Samuel Peter Laichour 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 Samuel Peter Laichour, No. 1:25-cv-01891-GSA 12 Plaintiff, OPINION & ORDER DIRECTING ENTRY OF JUDGMENT IN FAVOR OF 13 v. DEFENDANT COMMISSIONER OF SOCIAL SECURITY AND AGAINST 14 Commissioner of Social Security, PLAINTIFF 15 Defendant, (ECF No. 9, 11) 16 I. Introduction 17 Plaintiff Samuel Laichour appeals the Commissioner of Social Security’s denial of his 18 applications for child disability1 and supplemental security income (SSI). 19 II. Procedural Background 20 On September 1, 2022, Plaintiff applied for child disability and SSI alleging disability as of 21 October 11, 2007. The claims were denied initially and on reconsideration. On January 10, 2025, 22 the ALJ held a hearing. AR 38–76. On March 28, 2025, the ALJ issued an unfavorable decision. 23 AR 14–37. The Appeals Council denied review on October 26, 2025. Plaintiff then filed a 24 complaint in this Court. 25 26 1 As the ALJ explained, after the hearing and upon the advice of counsel, the claimant amended 27 the alleged disability onset date to October 11, 2022 (Exhibit 11D). This is when the claimant attained age 18. Therefore, the decision was under the adult disability rules only. AR 17. 28 1 III. The Disability Standard 2 Pursuant to 42 U.S.C. §405(g), this court has the authority to review the Commissioner’s 3 denial of disability benefits. “This court may set aside the Commissioner’s denial of disability 4 insurance benefits when the ALJ’s findings are based on legal error or are not supported by 5 substantial evidence in the record as a whole.” Tackett v. Apfel, 180 F.3d 1094, 1097 (9th Cir. 6 1999) (citations omitted). Substantial evidence is evidence within the record that could lead a 7 reasonable mind to accept a conclusion regarding disability status. See Richardson v. Perales, 402 8 U.S. 389, 401 (1971). It is more than a scintilla, but it is less than a preponderance. See Saelee v. 9 Chater, 94 F.3d 520, 522 (9th Cir. 1996). 10 The court must consider the whole record. If the evidence reasonably supports two 11 conclusions, the court must affirm the Agency’s decision. Jamerson v. Chater, 112 F.3d 1064, 12 1066 (9th Cir. 1997). 13 To qualify for benefits, a plaintiff must establish an inability to engage in substantial gainful 14 activity due to a medically determinable impairment that has lasted or can be expected to last for a 15 continuous period of not less than twelve months. 42 U.S.C. § 1382c(a)(3)(A). An individual shall 16 be considered to have a disability only if . . . his impairments are severe enough that he is not only 17 unable to do his previous work, but cannot, considering his age, education, and work experience, 18 engage in any other kind of substantial gainful work which exists in the national economy, 19 regardless of whether such work exists in the immediate area in which he lives, or whether a specific 20 job vacancy exists for him, or whether he would be hired if he applied for work. 42 U.S.C. 21 §1382c(a)(3)(B). 22 To achieve decision uniformity, the Commissioner established a five-step process for an 23 ALJ to employ. 20 C.F.R. §§ 416.920(a)-(f). The ALJ proceeds through the steps and stops upon 24 reaching a dispositive finding that the Claimant is or is not disabled. 20 C.F.R. §§ 416.927, 25 416.929. 26 Specifically, the ALJ is required to determine: 1- whether a Claimant has engaged in 27 substantial gainful activity during the period for which Plaintiff is alleging he or she experiences a 28 disability; 2- whether the Claimant has medically determinable “severe impairments” affecting the 1 Claimants ability to perform basic work activities; 3- whether these impairments meet or are 2 medically equivalent to one of the listed impairments in the agency’s regulations (20 C.F.R. § 404, 3 Subpart P, Appendix 1); 4- whether the Claimant has the RFC to perform past relevant work; and 4 5- whether the Claimant has the ability to perform other jobs existing in significant numbers at the 5 national and regional level. 20 C.F.R. § 416.920(a)-(f). While the Plaintiff bears the burden of 6 proof at steps one through four, the burden shifts to the commissioner at step five to prove that 7 Plaintiff can perform other work in the national economy given a Claimant’s RFC, age, education 8 and work experience. Garrison v. Colvin, 759 F.3d 995, 1011 (9th Cir. 2014). 9 IV. The ALJ’s Decision 10 At step one, the ALJ found that Plaintiff had not engaged in substantial gainful activity 11 (SGA) since the amended alleged onset date of October 11, 2022. AR 19–20. At step two, the ALJ 12 found Plaintiff had severe impairments of: autism spectrum disorder and borderline intellectual 13 functioning. AR 20. 14 At step three, the ALJ found Plaintiff did not have an impairment or combination thereof 15 that met or medically equaled one of the impairments listed in 20 C.F.R. Part 404, Subpart P, 16 Appendix 1. AR 22–23. 17 Prior to step four, the ALJ evaluated Plaintiff’s RFC and concluded Plaintiff had the RFC 18 for a full range of work at all exertional levels with the following non-exertional limitations:

19 he can understand, remember, and carry out simple instructions; he can occasionally interact with supervisors and coworkers; he cannot interact with the public; and he 20 can deal with occasional changes in a routine work setting. 21 AR 23–29 22 At step four, the ALJ found that Plaintiff had no past relevant work. AR 29. At step five, 23 the VE testified that considering Plaintiff’s vocational profile he could perform jobs existing in 24 significant numbers in the national economy, specifically housekeeping cleaner, industrial cleaner, 25 and kitchen helper. AR 29–31. 26 The ALJ thus concluded Plaintiff was not disabled. AR 31. 27 28 1 V. Brief Factual Background 2 Plaintiff has autism and was enrolled in special education through high school for severely 3 delayed speech and language, comprehension, and impaired social interaction. He graduated high 4 school and took online college courses. He socialized minimally with others at college because he 5 took only online courses. He had no group work, took one class per month and needed help with 6 registration. He had special accommodations of extra time for homework and tests, had a tutor, 7 and 1.5x time for assignments. 8 He couldn’t go out alone. His mother accompanied him to stores, helped with chores such 9 as laundry and handled his mail. He only talked with family members. Plaintiff’s clinicians noted 10 autism majorly impacted communication, self-care, and self-direction. One clinician opined off 11 task behavior would be 25% and precluded low stress work. The consultative examiner noted 12 intense eye contact, restricted facial expression, a slow rate of speech, sensitive sensory 13 functioning, and restricted affect. Intellectual testing results were low average in verbal 14 comprehension, perceptual reasoning, and working memory. 15 VI. Issues Presented 16 Plaintiff asserts five claims : A- “The ALJ failed to provide clear and convincing reasons 17 for discounting Plaintiff’s allegations of mental dysfunction” (MSJ at 6–10)2; B-“The ALJ failed 18 to properly evaluate the treating medical source opinion of Kutraj Sidhu, M.D.” (MSJ at 11–15); 19 C- “The ALJ failed to properly evaluate the examining medical source opinion of the psychological 20 consultative examiner Tikesha Leslie-Jones, Ph.D.” (MSJ at 15–20); D- “The ALJ failed to 21 properly evaluate the medical source opinion of the State agency psychological consultant Joan 22 Joynson, Ph.D.;” (MSJ at 20–22); and, E- “The ALJ failed to provide germane reasons for 23 discounting the testimony of Plaintiff’s mother.” (MSJ at 22–25).

24 A. The ALJ failed to provide clear and convincing reasons for discounting Plaintiff’s allegations of mental dysfunction 25 1. Applicable Law 26

27 2 Notably, there is significant overlap between Plaintiff’s claim concerning the improper rejection of Plaintiff’s subjective testimony, the opinions of the medical experts, and the testimony of his 28 mother. The Court will endeavor to address each individually. 1 Before proceeding to steps four and five, the ALJ determines the claimant’s residual 2 functional capacity (RFC), which is the most that a claimant can do despite the claimant’s particular 3 limitations. The RFC is “based on all the relevant evidence.” 20 C.F.R. § 416.945(a)(1). The RFC 4 must consider all impairments, both severe and non-severe. 20 C.F.R. §§ 416.920(e), 5 416.945(a)(2). An ALJ meets this burden with a thorough summary and interpretation of facts and 6 conflicting evidence. Magallanes v. Bowen, 881 F.2d 747, 751 (9th Cir. 1989). 7 An ALJ performs a two-step analysis to determine whether a Plaintiff’s testimony regarding 8 subjective pain or symptoms is credible. See Garrison v. Colvin, 759 F.3d 995, 1014 (9th Cir. 9 2014); Smolen, 80 F.3d at 1281; SSR 16-3p. First, the claimant must produce objective medical 10 evidence of an impairment that could reasonably be expected to produce some degree of the 11 symptom or pain alleged. Garrison, 759 F.3d at 1014; Smolen, 80 F.3d at 1281–82. If the claimant 12 satisfies step one and the ALJ finds no malingering in the record, the ALJ must then evaluate the 13 intensity, persistence and limiting effects of the claimant’s symptoms to determine the extent to 14 which those symptoms limit the claimant’s ability to perform work activities. SSR 16-3p at 2. 15 An ALJ’s evaluation of a claimant’s testimony must be supported by specific, clear and 16 convincing reasons. Burrell v. Colvin, 775 F.3d 1133, 1136 (9th Cir. 2014); see also SSR 16-3p. 17 Subjective testimony cannot be rejected on the sole ground that the testimony is not entirely 18 corroborated by the objective medical evidence in the record. Nevertheless, the medical evidence 19 is still a relevant factor in determining the severity of Claimant’s pain and its disabling effects. See, 20 Rollins v. Massanari, 261 F.3d 853, 857 (9th Cir. 2001); SSR 16-3p (citing 20 C.F.R. § 21 404.1529(c)(2)). 22 In addition, other factors considered are: 1- daily activities; 2- the location, duration, 23 frequency, and intensity of pain or other symptoms; 3- any applicable precipitating and aggravating 24 factors; 4- the type, dosage, effectiveness, and side effects of any prescribed medication; 5- 25 treatment other than medications that the claimant receives; 6- any other measures the claimant 26 uses to relieve pain or other symptom; and 7- other factors concerning the claimant’s functional 27 limitations and restrictions due to pain or other symptoms. See, 20 C.F.R. § 416.929(c)(3). 28 2. Analysis 1 Because the ALJ found that “the claimant’s medically determinable impairments could 2 reasonably be expected to cause the alleged symptoms,” and found no malingering (AR 23), the 3 ALJ’s evaluation of the claimant’s testimony must be supported by specific, clear and convincing 4 reasons. Burrell v. Colvin, 775 F.3d 1133, 1136 (9th Cir. 2014); see also S.S.R. 16-3p at *10. 5 Here, the ALJ found that “the claimant’s statements concerning the intensity, persistence, 6 and limiting effects of these symptoms are not entirely consistent with the medical evidence and 7 other evidence in the record for the reasons explained in this decision.” AR 23. The ALJ then 8 proceeded to discuss Plaintiff’s medical history, which follows. AR 24–29. 9 First, Plaintiff contests the ALJ’s finding that he had no specialized mental health 10 treatment. MSJ at 8. Plaintiff cites his individual program plan (IPP) with the Central Valley 11 Regional Center (CVRC)3 for the years at issue, 2022 to 2024 (AR 659–71), which reflect 12 Plaintiff’s effort to improve in his independent decision-making, daily living, self-care, 13 relationships, and health despite his life-long diagnosis of autism.

14 Plaintiff’s full argument is as follows: 15 Here, the ALJ’s analysis failed to satisfy the clear and convincing standard. 16 First, the ALJ rejected Plaintiff’s allegations of mental dysfunction because the ALJ found that they were not consistent with the record that showed Plaintiff had no 17 specialized mental health treatment (Tr. 27). However, contrary to the ALJ’s findings, the record showed Plaintiff had pursued appropriate mental health 18 treatment for his autistic spectrum disorder. For instance, the record included 19 Plaintiff’s individual program plan [IPP] with the Central Valley Regional Center4 for the years during the period at issue, namely 2022 to 2024 (Tr. 659-671). These 20 notes reflected Plaintiff’s effort to improve in his independent decision-making, daily living, self-care, relationships, and health despite his life-long diagnosis of 21 autism (Tr. 659-671). For instance, Plaintiff’s treatment plan noted how he only socialized with his parents but wanted to work on socializing with others (Tr. 661). 22 Plaintiff’s records from Central Valley Regional Center showed that he was being 23 followed for his autism. The ALJ did not explain what type of treatment she expected for Plaintiff’s autism that was missing from the record (Tr. 27). See 24 Lapeirre-Gutt v. Astrue, 382 Fed.Appx. 662, 664 (9th Cir. June 9, 2010) (“claimant cannot be discredited for failing to pursue non-conservative treatment options where 25 none exist.”); see also Revels v. Berryhill, 874 F.3d 648, 667 (9th Cir. 2017) (“Any 26

27 4 “CVRC provides assessments, evaluations, programs, activities, and case management for people who experience intellectual and developmental disabilities.” https://www.cvrc.org/about- 28 us/ 1 evaluation of the aggressiveness of a treatment regimen must take into account the condition being treated”); Moon v. Colvin, 139 F.Supp.3d 1211, 1220 (D. Or. 2015) 2 (“the fact that treatment may be routine or conservative is not a basis for finding subjective symptom testimony unreliable absent discussion of the additional, more 3 aggressive treatment options the ALJ believes are available.”) (citing Lapeirre– 4 Gutt, 382 Fed.Appx. at 664). Thus, because Plaintiff received appropriate treatment for his autism, the ALJ’s rationale was not clear and convincing. 5 MSJ at 8. 6 7 The cited records from CVRC reflect three visits during the period of October 2022 to 2024, 8 during which Plaintiff and his clinician developed an individualized program plan (IPP) for each 9 upcoming year. AR 659-71. 10 In analyzing Plaintiff’s contention that he had no specialized mental health treatment, it 11 seems more helpful to address the content of Plaintiff’s IPPs rather than simply categorizing his 12 CVRC as specialized or non-specialized. 13 Plaintiff’s argument above emphasizes his goal to improve his social skills noting that he 14 15 only socialized with his parents but wanted to work on socializing with others. AR 661. To the 16 extent Plaintiff continues to have ongoing social deficiencies, these are reflected in the RFC which 17 specifies no public contact and only occasional interaction with supervisors and coworkers. AR 18 23. Further, Plaintiff’s social deficiencies were not emblematic of his IPPs as a whole. For 19 example, Plaintiff’s IPP from October 12, 2023 reflects the following: 20 How I communicate my needs and preferences: I can communicate verbally what 21 I want and how I feel freely with my support group and abroad - I can communicate openly with parents. I have been told that I can be direct or to the point in 22 conversation. 23 Ways to approach me that help me to respond: I respond well to others who can acknowledge my feelings and those who are also direct with me. I may need things 24 reexplained, but patience and reassurance are key. Decisions I make on my own or with help from others: I can decide where I want 25 to go, and my parents assist me by driving me there. I decide what I eat and can make simple meals on my own, I also pick my own clothes. My parents help me 26 maintain a schedule and routine for myself, but it is centered around things I enjoy 27 doing like working out, and school. I will usually tell parents what I want, but they will ask me what I want as well 28 What is Important To me: School and my education is important to me, I love 1 learning. Getting out of the house often is also important to me, I am not a homebody and I like to have things to do. 2 What is Important For me: My health is important for me; I work out regularly. Support from my family is also important for me. 3 . . . 4 What is happening now: I can bathe, use the restroom, brush my hair and teeth, put on deodorant, and make simple meals for myself in the microwave. My dad is 5 assisting me with shaving as needed, I can do it independently, but it is not always a very even shave. I have a skin care regimen that I follow without assistance. I pick 6 my own clothes and dress myself; I may need reminders to wear a jacket if it is cold 7 outside. I am now taking out the trash, doing laundry and dishes independently. My family offers positive reinforcement and allows me to try to do things independently 8 first. How and where I spend my time during an entire week: I am enrolled in 9 University of Phoenix online . . . I am excelling in college and even working ahead of the schedule. . . 10 What pleases me about how and where I spend my time: I love to learn and I 11 love having classes from home, I really thrive in that setting. I was going to school for psychology, but I am very interested in anything that involves computers or 12 technology. We are evaluating my strengths and interests currently. My mom will have me try things on my own first and if I need help, she will jump in, but first I 13 try to use google for help or have my computer read what I’ve typed back to me. I love to go to the library to pick out new books as well as games. 14

15 AR 659–61.

16 These statements by Plaintiff reflect that he had relatively intact functionality and 17 independence in day-to-day tasks, and importantly the ALJ identified many of these findings in 18 support of the RFC. AR 26. 19 The ALJ also explained: 20 In 2022 and 2023, the claimant was told that CVRC offers independent 21 living skills resources, but the claimant did not access those services (Exhibits 9F, p. 2; 18F, p. 3), there are also Employment First and social recreation opportunities 22 that the claimant has not accessed (Exhibit 18F, p. 3), and additionally there are 23 social skills classes (Exhibit 18F, p. 4). The claimant has not requested services or expressed a need for those services, and he primarily received assistance from his 24 parents. In 2024, the plan indicated that independent living skills services, employment first services, and social recreation opportunities were discussed, and 25 the claimant would reach out if interested (Exhibit 18F, p. 11). The claimant was also to indicate if he would participate in social skills classes, but he has not 26 indicated he would (Exhibit 18F, p. 12). In 2022 and 2023, the claimant was told 27 that CVRC offers independent living skills resources, but the claimant did not access those services (Exhibits 9F, p. 2; 18F, p. 3), there are also Employment First and 28 social recreation opportunities. 1 AR 25–26 (emphasis added). 2

Therefore, at least as to social skills, Plaintiff is not quite accurate in asserting that the ALJ 3 4 did not identify any specialized treatment that Plaintiff could have accessed but failed to (MSJ at 5 8) as the ALJ in fact identified several opportunities Plaintiff was offered to improve social 6 functioning which he apparently failed to do. 7 Further, beyond social skill deficiencies, the RFC accounts for other deficiencies Plaintiff 8 identified. For example, Plaintiff explained in his IPP questionnaire: 9 I can get nervous when my routine/plans are changed last minute, or if I have made a 10 mistake but my mom reassures me that everything is okay and that mistakes happen. lf there 11 is going to be a change in my routine, my parents will try to let me know ahead of time - that makes me feel better about it. My parents have been preparing my items for me before 12 we leave the house, such as making sure I have my phone and house key. Through this routine of getting everything together before we leave, I have begun checking in with my 13 parents to make sure they have their items as well. My mom says that I am becoming more observant of those kinds of things, I will even make sure my dad has what he needs to 14 regulate his diabetes before we leave the house. 15 AR 662. 16 In accounting for these statements, the RFC reflects that Plaintiff can deal with only 17 occasional changes in a routine work setting. AR 23. 18 19 Next, Plaintiff contests the ALJ’s finding that an inconsistency exists between Plaintiff’s 20 statements and the objective medical evidence. AR 27. Plaintiff contends that “contrary to the 21 ALJ’s findings, on exam with the agency-ordered consultative examination, Plaintiff had intense 22 eye contact; restricted facial expression; slow rate of speech; sensitive sensory functioning; and 23 restricted affect. AR 511, 513. Such findings aligned with Plaintiff’s alleged difficulty interacting 24 with others.” MSJ at 9. 25 However, as set forth above, social interaction limitations were accounted for in the RFC 26 27 including no contact with the general public and only occasional interaction with supervisors and 28 coworkers. AR 23. 1 Plaintiff further emphasizes that “intellectual testing showed low average results in his 2 verbal comprehension, perceptual reasoning, and working memory.” MSJ at 9 (citing AR 513– 3 14.). Plaintiff contends the ALJ “failed to explain why these abnormal findings were not consistent 4 with Plaintiff’s allegations – allegations which included difficulties interacting with others and 5 completing tasks without help.” MSJ at 9. 6 7 Again, Plaintiff’s self-description of his own capabilities, as set forth above, reflect an 8 ability to complete tasks without help. His “low-average” intelligence results corresponded to the 9 19th, 12th, and 18th percentiles, which arguably cannot be said to reflect a disabling level of 10 intellectual limitations that would preclude all gainful employment. AR 513–14. 11 The ALJ also relied on good grades in college (AR 27), although Plaintiff emphasizes he 12 was afforded accommodations of one class at a time, a tutor, and 1.5x time for assignments and 13 contends that “The ALJ failed to explain how Plaintiff’s success at school with accommodations 14 15 translated to the ability to succeed (without accommodations) at a fulltime job.” MSJ at 9. Yet the 16 RFC does not reflect that Plaintiff requires no accommodations for full time work as it found that 17 he could carry out simple instructions with occasional interaction with supervisors and coworkers, 18 none with the public, and only occasional changes in a routine work setting. AR 23. 19 Plaintiff further emphasizes that, per the VE’s testimony, “there were no competitive jobs 20 available for an individual who needed 50% more time than expected to complete job tasks.” MSJ 21 at 9 (citing AR 66–67). However, the fact that he was allowed 1.5x time to complete assignments, 22 23 standing alone, offers only weak inferential support the conclusion that he would require the same 24 accommodation in a work setting. 25 Finally, Plaintiff argues: 26 Lastly, the ALJ rejected Plaintiff’s allegations because the ALJ found that they were 27 not consistent with his daily activities (Tr. 27). However, the record showed that Plaintiff was only able to go out to a store if his parents stayed nearby (Tr. 71). 28 Plaintiff needed help with his household chores (Tr. 72). His parents needed to read 1 and sort out the important mail for him (Tr. 56). The ALJ again failed to provide a meaningful explanation as to how any of Plaintiff’s daily activities translated to a 2 competitive job. The record showed Plaintiff was an autistic adult who required his parents help shopping, doing homework, and performing chores. Because these 3 activities, reflecting Plaintiff’s difficulty with independent living, fully supported 4 Plaintiff’s alleged mental dysfunction, the activities did not constitute a clear and convincing reason for the ALJ to discount Plaintiff’s reported mental symptoms. 5 See Garrison, 759 F.3d at 1016 (the Ninth Circuit has repeatedly warned that “impairments that would unquestionably preclude work and all the pressures of a 6 workplace environment will often be consistent with doing more than merely resting 7 in bed all day.”).

8 MSJ at 10.

9 However, as to the quote provided from the Garrison case, Plaintiff apparently does much 10 more beyond resting in bed as he stated that he “is not a homebody” and likes to get out of the 11 house and have things to do. 12 In sum, Plaintiff’s self-described abilities as depicted in the record are far greater than he 13 is currently alleging in this appeal. See AR 659–671 (corrects mom if they miss a turn; 14 15 independently makes simple meals, picks up clothes, takes out trash, does dishes and laundry, 16 works out 30 minutes per day on a treadmill, maintains personal hygiene, grooming, and skin care 17 regimen, excels in school other than social interaction, and ensures his dad has his diabetes 18 medication before leaving the house.) AR 659–671. And even though Plaintiff emphasizes his 19 “need for support with even routine daily activities,” he only offers one example, that of going 20 shopping, albeit while independently using self-checkout. Thus, Plaintiff’s claimed limitations are 21 far outweighed by his other independent activities noted on his IPP forms. 22 23 B. The ALJ failed to properly evaluate the treating medical source opinion of Kutraj Sidhu, M.D 24 1. Applicable Law 25 26 For applications filed on or after March 27, 2017, new regulations eliminate a hierarchy of 27 medical opinions and provide that “[w]e will not defer or give any specific evidentiary weight, 28 1 including controlling weight, to any medical opinion(s) or prior administrative medical finding(s), 2 including those from your medical sources.” 20 C.F.R. § 404.1520c(a). Instead, when evaluating 3 any medical opinion, the regulations provide that the ALJ will consider the factors of supportability, 4 consistency, treatment relationship, specialization and other factors. 20 C.F.R. § 404.1520c(c). 5 Supportability and consistency are the two most important factors, and the agency will 6 articulate how the factors of supportability and consistency are considered. Id. “Even under the 7 new regulations, an ALJ cannot reject an examining or treating doctor's opinion as unsupported or 8 inconsistent without providing an explanation supported by substantial evidence.” Woods v. 9 Kijakazi, 2022 WL 1195334, (9th Cir. Apr. 22, 2022) at *6. 10 With respect to “supportability,” the new regulations provide that “[t]he more relevant the 11 objective medical evidence and supporting explanations presented by a medical source are to 12 support his or her medical opinion(s) or prior administrative medical finding(s), the more 13 persuasive the medical opinions or prior administrative medical finding(s) will be.” 20 C.F.R. § 14 416.920c(c)(1). Regarding “consistency,” the regulations provide that “[t]he more consistent a 15 medical opinion(s) or prior administrative medical finding(s) is with the evidence from other 16 medical sources and nonmedical sources in the claim, the more persuasive the medical opinion(s) 17 or prior administrative medical finding(s) will be.” 20 C.F.R. § 416.920c(c)(2). 18 2. Analysis 19 Plaintiff’s treating physician, Dr. Sidhu, opined that Plaintiff had moderate limitations in 20 the categories: 1- understand, remember, or apply information; 2- interact with others; 3- 21 concentrate, persist, or maintain pace; and 4- adapt or manage himself. AR 520–21. 22 Dr. Sidhu specifically opined that Plaintiff had moderate limitations in his ability to: 1- 23 remember locations and procedures; 2- perform very short and simple instructions; 3- carry out 24 detailed instructions; 4- adhere to a punctual schedule, maintain attendance; 5- perform without 25 special supervision; 6- work with others without distraction them or himself; 7- complete a normal 26 workday/workweek without interruptions from symptoms; 8- maintain pace without extra rest 27 periods; 9- maintain socially appropriate behavior and cleanliness; and 10- respond appropriately 28 to workplace changes (AR 520–22). He further opined that Plaintiff had marked limitations in his 1 ability to: 1- carry out detailed instructions; 2- maintain extended attention and concentration; 3- 2 make simple decisions; 4- interact with the general public; 5- ask simple questions or request 3 assistance; 6- avoid hazards and to take precautions; 7- travel in unfamiliar places or use public 4 transportation; and 8- independently set realistic goals or make plans independently. AR 522 5 First, as to moderate limitations, they are not per se disabling. See, Rose M. E. v. Saul, 6 2021 WL 1612091, at *3 (C.D. Cal. Apr. 26, 2021) (SSA defines moderate limitations to mean 7 ‘[t]here is more than a slight limitation in this area, but the individual can still function 8 satisfactorily.’”). 9 Second, as to the marked limitations, some are inapplicable given the RFC. For example: 10 1-Dr. Sidhu precluded detailed instructions, but the RFC only requires simple ones (AR 23); 2- Dr. 11 Sidhu precluded interaction with the general public, and the RFC specified that Plaintiff cannot 12 interact with the general public. AR 25. 13 As for the 1.5x time accommodation, it is difficult to justify that this somewhat modest 14 accommodation constitutes a markedly limited capacity as opposed to being classified as a mild or 15 moderate limitation in the ability to maintain attention and concentration, especially given that 16 Plaintiff earned a 3.72 GPA which arguably demonstrates adequate attention and concentration. 17 Dr. Sidhu further opined that Plaintiff had marked limitations in setting realistic goals, 18 however Plaintiff’s IPP plan indicated he intended to graduate college at the University of Phoenix 19 (AR 659–671), and the record reveals that he was on track to do so. 20 As to allegedly marked limitations in asking simple questions or requesting assistance, 21 Plaintiff’s IPP plan suggests otherwise when Plaintiff states, “I respond well to others who can 22 acknowledge my feelings and those who are also direct with me. I may need things reexplained, 23 but patience and reassurance are key. I prefer to interact with others on my own terms, but I will 24 respond if approached.” AR 679. 25 Finally, as to the opined marked limitations in ability to travel in unfamiliar places or use 26 public transportation, in conflict is a statement by Plaintiff contained in an IPP plan where Plaintiff 27 explained, “I can decide where I want to go, and my parents assist me by driving me there” (AR 28 659). Plaintiff has also stated that he is not a homebody, likes to get out of the house, plans to travel 1 more, and to visit the Arc Experience in Kentucky. AR 673. 2 Thus, Dr. Sidhu’s opinion warranted no changes to the RFC.

3 C. The ALJ failed to properly evaluate the examining medical source opinion of the psychological consultative examiner Tikesha Leslie- 4 Jones, Ph.D. 5 To begin, the limitations and related evidence in this claim are largely duplicative of the 6 above discussion. 7 Here, Dr. Leslie-Jones conducted a consultative psychiatric evaluation at the request of the 8 agency. AR 511. On exam, Plaintiff had intense eye contact, restricted facial expression, slow 9 speech, sensitive sensory functioning, and restricted affect. AR 511, 513. Plaintiff’s intellectual 10 testing showed low average results in his verbal comprehension, perceptual reasoning, and working 11 memory. AR 513–514. Dr. Leslie-Jones opined that Plaintiff had: 1- moderate limitations as to 12 detailed and complex tasks; 2- moderate limitations as to consistency; 3- moderate to significant 13 limitations as to performing without special supervision; 4- moderate to significant limitations in 14 completing a normal workday or workweek without psychiatric interruptions; 5- significant 15 limitations in social interaction; and 6- significant limitations in his ability to manage workplace 16 stress. AR 516–17. 17 Here again, the opined moderate limitations as to detailed and complex tasks are reflected 18 in the RFC which requires only simple tasks. AR 23. Social interaction is also reflected in the 19 RFC which specifies occasional supervisor and co-worker interaction and no interaction with the 20 general public. AR 23. 21 As for limitations in stress tolerance, they are likewise reflected in the RFC for simple tasks, 22 and simple tasks encompass low stress tolerance. Henry v. Colvin, No. 1:15-cv-00100-JLT, 2016 23 WL 164956, at *18 (E.D. Cal. Jan. 14, 2016) (simple tasks encompasses low stress tolerance); 24 Keller v. Colvin, No. 2:13-cv-0221-CKD, 2014 WL 130493, at *3 (E.D. Cal. Jan. 13, 2014) (simple 25 tasks “appropriately captured” physician's opinion that claimant required “low stress settings”)). 26 As to opinions 1 through 4 above, it is again worth noting that moderate limitations as a 27 whole are not per se disabling. See, Rose, 2021 WL 1612091, at *3 (SSA defines a ‘moderate’ 28 1 limitation to mean ‘[t]here is more than a slight limitation in this area, but the individual can still 2 function satisfactorily.’”) 3 As for the opined limitations regarding Plaintiff’s ability to perform work activities 4 consistently without additional supervision and without interruptions resulting from his psychiatric 5 condition, as the ALJ explained, they are belied Plaintiff’s success in school. 6 As to the VE’s testimony that 10% off-task behavior is the threshold beyond which it would 7 not be tolerated in the workplace (AR 64), it is not clear whether “moderate” or “moderate to 8 significant” limitations equate to more than 10% of a workday. 9 Plaintiff finally emphasizes that his intellectual testing was low average in verbal 10 comprehension, perceptual reasoning, and working memory (AR 513–514), corresponding to the 11 19th, 12th, and 18th percentiles. Yet it cannot be said here that these necessarily reflect disabling 12 intellectual limitation, particularly given other metrics of intellectual capacity such as Plaintiff’s 13 educational accomplishments. 14 Thus, the ALJ committed no error with respect to the opinions of the psychological 15 consultative examiner Tikesha Leslie-Jones, Ph.D.

16 D. The ALJ failed to properly evaluate the medical source opinion of the State agency psychological consultant Joan Joynson, Ph.D. 17 Dr. Joynson reviewed the record and opined that Plaintiff was limited to simple and 18 repetitive work, was limited to 1 to 3 step tasks, was limited to work with only occasional changes, 19 was able to adequately respond to coworkers and supervisors, and was limited to low public contact. 20 AR 109, 120. The ALJ found the opinion persuasive and supported. Plaintiff argues as follows: 21 Despite this finding, though, the ALJ failed to incorporate crucial limitations 22 assessed by Dr. Joynson. In particular, while Dr. Joynson opined that Plaintiff was limited to 1 to 3 step instructions (Tr. 109, 120), the ALJ’s residual functional 23 capacity did not include a corresponding limitation (Tr. 23). Rather, the ALJ found that Plaintiff was able to perform simple instructions (Tr. 23). 24 The ALJ’s error was harmful. The Ninth Circuit has found that there is an 25 apparent conflict between a restriction to 1 and 2 step tasks and the ability to perform an occupation with a Dictionary of Occupational Titles (DOT) Reasoning Level of 26 2. See Rounds v. Comm’r of Soc. Sec., 807 F.3d 996, 1003 (9th Cir. 2015). By extension, some courts within the Ninth Circuit have held that a claimant restricted 27 to 3-step tasks could not necessarily perform occupations requiring a DOT 28 Reasoning Level of 2; and thus, an ALJ’s failure to incorporate a restriction to 3- 1 step tasks in the claimant’s RFC was not harmless error. See Diane Kay W. v. Saul, Case No. 20-5641-MAT, 2020 WL 7241428, *2-3 (W.D. Wash. Dec. 9, 2020) 2 (“there is no evidence that every reasoning level two job requires no more than three- step tasks. And there is no evidence in the record that the jobs the ALJ relied on 3 required only three-step tasks…at step five, it is the Commissioner who bears the 4 burden to show that a claimant is not disabled because he or she can perform work that exists in significant numbers in the national economy.”). MSJ at 20 (emphasis 5 added). 6 To begin, the 9th Circuit has found that there is an apparent conflict between a restriction 7 of 1 and 2 step tasks with jobs having a Reasoning Level of R2. See Rounds v. Comm’r of Soc. 8 Sec., 807 F.3d 996, 1003 (9th Cir. 2015). 9 Importantly as pointed out above, Dr. Joynson did not opine that plaintiff was limited to 1 10 to 2 step tasks, but rather opined that Plaintiff was limited to 1 to 3 step instructions. The question 11 presented then is whether this limitation precludes Plaintiff from performing jobs that require a 12 DOT reasoning level of R2.5 13 Further, as Defendant emphasizes, several district courts in this circuit have found a 14 restriction to 1 to 3 step tasks to be consistent with a limitation to simple work and/or jobs with a 15 DOT reasoning level of R2. See, e.g., Kaitlyn B. v. Comm’r of Social Sec., 2021 WL 2432324, at 16 *5 (W.D. Wash. June 15, 2021); Howard v. Saul, 2020 WL 7490378, at *3 (D. Nev. Dec. 18, 2020); 17 Ray v. Comm’r of Social Sec. Admin., 2019 WL 77432, at *1 (W.D. Wash. Jan. 2, 2019); Bannister 18 v. Colvin, 2016 WL 5141722, at *5 (W.D. Wash. Sep. 21, 2016); Pharris v. Astrue, 2011 WL 19 3882508, at *12 (E.D. Cal. Sep. 2, 2011) (finding an RFC restriction to “simple routine tasks” to 20 be consistent with “[a] limitation to three and four step instructions” and jobs requiring Level 2 21 reasoning). 22 Plaintiff identifies only 1 case suggesting otherwise, that being Diane Kay W, 2020 WL 23 7241428 at *2-3 (W.D. Wash. Dec. 9, 2020). But even if Plaintiff were correct that Dr. Joynson’s 24 opined limitation to 1 to 3 step tasks did preclude jobs with a DOT reasoning level of R2, as noted 25 in the footnote below, that would not affect the outcome here as the VE did identify 1 job with a 26 reasoning level of only R1, housekeeping cleaner, DOT 323.687-014. 27

28 5 Even if so, the VE identified an R1 job, namely housekeeping cleaner, DOT 323.687-014. 1 Thus, the ALJ committed no error with respect to Dr. Joynson’s opinion which limited 2 Plaintiff to 1 to 3 step tasks, and which is adequately encapsulated by the RFC restriction for simple 3 work because simple work does not preclude jobs that have a DOT reasoning level of R1 or R2.

4 E. The ALJ failed to provide germane reasons for discounting the testimony of Plaintiff’s mother. 5 Plaintiff’s mother testified that Plaintiff had the following special accommodations in 6 college: extra time for homework, tests, and responses to other students’ work. AR 69–70. 7 Plaintiff’s mother also testified that he needed her around at the store (AR 71), and that he needed 8 help with household chores. AR 72. AR 69–71. 9 To begin, lay witness testimony is “competent evidence that an ALJ must take into account, 10 unless he or she expressly determines to disregard such testimony and gives reasons germane to 11 each witness for doing so.” Lewis v. Apfel, 236 F.3d 503, 511 (9th Cir. 2001); see also Vincent on 12 Behalf of Vincent v. Heckler, 739 F.2d 1393, 1394 (9th Cir. 1984) (the ALJ must explain why 13 “significant probative evidence has been rejected”). 14 Here, because Plaintiff’s self-described subjective complaints/limitations are arguably so 15 similar to that of his mother’s testimony, the “germane to each witness” requirement is satisfied 16 and no additional explanation by the ALJ is required beyond what the ALJ explained concerning 17 Plaintiff’s own account of his complaints/limitations. Moreover, when an ALJ’s reasoning is 18 sufficient for rejecting a Plaintiff testimony, and that testimony is similar to another lay witnesses’ 19 testimony, then that reasoning is equally applicable to the lay witness. See Valentine v. Comm’r 20 Soc. Sec. Admin., 574 F.3d 685, 694 (9th Cir. 2009) (where the ALJ gave clear and convincing 21 reasons for rejecting the claimant’s own subjective complaints, and the lay witness’s testimony was 22 similar, it follows that the ALJ also gave germane reasons for rejecting the lay witness’s 23 testimony.). 24 Thus, the ALJ did not err with respect to Plaintiff mother’s testimony. 25 VII. Conclusion and Order 26 Substantial evidence and applicable law support the ALJ’s conclusion that Plaintiff was not 27 disabled. 28 1 Accordingly, it is ordered that: 2 1. Plaintiff’s motion for summary judgment (Doc. 9) is DENIED. 3 2. Defendant’s cross motion (Doc. 11) is GRANTED. 4 3. The Commissioner’s Decision is AFFIRMED 5 4. The Clerk of Court is directed to enter judgment in favor of Defendant 6 Commissioner of Social Security and against Plaintiff. 7

8 IT IS SO ORDERED.

9 Dated: May 25, 2026 /s/ Gary S. Austin_______________ 10 UNITED STATES MAGISTRATE JUDGE 11 12 13 14 15 16 17 18 19 20 21 22 23 24 25 26 27 28