Sheila M. v. Frank Bisignano, Commissioner of Social Security

Opinion

Mar 23, 2026 1

2 SEAN F. MCAVOY, CLERK

UNITED STATES DISTRICT COURT 3 EASTERN DISTRICT OF WASHINGTON 4 5 SHEILA M., No. 1:24-CV-03163-JAG

6 Plaintiff, ORDER AFFIRMING 7 v. THE DECISION OF THE ADMINISTRATIVE LAW 8 FRANK BISIGNANO, JUDGE 9 Commissioner of Social Security,1

10 Defendant. 11 12 BEFORE THE COURT is Plaintiff’s Opening Brief and the 13 Commissioner’s Brief in response. ECF Nos. 10, 15. Attorney D. James Tree 14 represents Sheila M. (Plaintiff); Special Assistant United States Attorney Ryan Lu 15 represents the Commissioner of Social Security (Defendant). The parties have 16 17 consented to proceed before the undersigned by operation of Local Magistrate 18 Judge Rule (LMJR) 2(b)(2), as no party returned a Declination of Consent Form to 19 the Clerk’s Office by the established deadline. ECF No. 3. After reviewing the 20 administrative record and briefs filed by the parties, the Court AFFIRMS the 21 Administrative Law Judge’s (ALJ) decision. 22 I. JURISDICTION 23 Plaintiff filed her most recent applications for Disability Insurance Benefits 24 and Supplemental Security Income on August 31, 2021, alleging disability since 25 June 16, 2021, due to ADHD, DDD, Fibromyalgia, IBS, PTSD, Anxiety/ 26

27 1 Pursuant to Rule 25(d) of the Federal Rules of Civil Procedure, Frank Bisignano 28 is substituted as the defendant in this suit. Depression, Bipolar, Memory Issues, Panic Attacks, and Possible Autistic. 1 2 Tr. 373, 394, 411. Plaintiff previously applied for and was denied benefits alleging 3 different onset dates twice. Plaintiff’s most recent claim was denied initially and 4 on reconsideration, and she requested a hearing before an ALJ. Tr. 241, 251, 282, 5 301. A hearing was held on November 2, 2023, at which vocational expert Mark 6 Harrington, and Plaintiff, who was represented by counsel, testified. Tr. 39-40. 7 ALJ Laura Valente presided. Tr. 39. At the hearing, counsel moved to amend the 8 onset date to September 15, 2021. The ALJ denied benefits on December 13, 9 2023. Tr. 14. The Appeals Council denied review. Tr. 1. The ALJ’s decision 10 became the final decision of the Commissioner, which is appealable to the district 11 court pursuant to 42 U.S.C. § 405(g). Plaintiff filed this action for judicial review 12 on October 14, 2024. ECF No. 1. 13 II. STATEMENT OF FACTS 14 The facts of the case are set forth in detail in the transcript of proceedings 15 and the ALJ’s decision and are only briefly summarized here. Plaintiff was born in 16 1972 and was 49 years old on the amended alleged onset date. Tr. 373. 17 Plaintiff’s past jobs include fruit sorting. Tr. 432. 18 III. STANDARD OF REVIEW 19 The ALJ is responsible for determining credibility, resolving conflicts in 20 medical testimony, and resolving ambiguities. Andrews v. Shalala, 53 F.3d 1035, 21 1039 (9th Cir. 1995). The ALJ’s determinations of law are reviewed de novo, with 22 23 deference to a reasonable interpretation of the applicable statutes. McNatt v. Apfel, 24 201 F.3d 1084, 1087 (9th Cir. 2000). The decision of the ALJ may be reversed 25 only if it is not supported by substantial evidence or if it is based on legal error. 26 Tackett v. Apfel, 180 F.3d 1094, 1097 (9th Cir. 1999). Substantial evidence is 27 defined as being more than a mere scintilla, but less than a preponderance. 28 Id. at 1098. Put another way, substantial evidence is such relevant evidence as a reasonable mind might accept as adequate to support a conclusion. Richardson v. 1 2 Perales, 402 U.S. 389, 401 (1971). If the evidence is susceptible to more than one 3 rational interpretation, the Court may not substitute its judgment for that of the 4 ALJ. Tackett, 180 F.3d at 1097; Morgan v. Commissioner of Social Sec. Admin., 5 169 F.3d 595, 599 (9th Cir. 1999). If substantial evidence supports the 6 administrative findings, or if conflicting evidence supports a finding of either 7 disability or non-disability, the ALJ’s determination is conclusive. Sprague v. 8 Bowen, 812 F.2d 1226, 1229-1230 (9th Cir. 1987). Nevertheless, a decision 9 supported by substantial evidence will be set aside if the proper legal standards 10 were not applied in weighing the evidence and making the decision. Brawner v. 11 Secretary of Health and Human Services, 839 F.2d 432, 433 (9th Cir. 1988). 12 IV. SEQUENTIAL EVALUATION PROCESS 13 The Commissioner established a five-step sequential evaluation process for 14 determining whether a person is disabled. 20 C.F.R. §§ 404.1520(a), 416.920(a); 15 see Bowen v. Yuckert, 482 U.S. 137, 140-42 (1987). In steps one through four, the 16 burden of proof rests upon the claimant to establish a prima facie case of 17 entitlement to disability benefits. Tackett, 180 F.3d at 1098-99. This burden is 18 met once a claimant establishes that a physical or mental impairment prevents him 19 from engaging in past relevant work. 20 C.F.R. §§ 404.1520(a)(4), 416.920(a)(4). 20 If a claimant cannot do their past relevant work, the ALJ proceeds to step five, and 21 the burden shifts to the Commissioner to show that (1) the claimant can make an 22 23 adjustment to other work; and (2) the claimant can perform specific jobs that exist 24 in the national economy. Batson v. Comm’r of Soc. Sec. Admin., 359 F.3d 1190, 25 1193-94 (9th Cir. 2004). If a claimant cannot make an adjustment to other work in 26 the national economy, the claimant will be found disabled. 20 C.F.R. §§ 27 404.1520(a)(4)(v), 416.920(a)(4)(v). 28 1 V. ADMINISTRATIVE FINDINGS 2 On December 13, 2023, the ALJ issued a decision finding Plaintiff was not 3 disabled as defined in the Social Security Act. 4 At step one, the ALJ found that Plaintiff had not engaged in substantial 5 gainful activity since the amended onset date of September 15, 2021. Tr. 19. 6 At step two, the ALJ found Plaintiff had the severe impairments of 7 depressive disorder; anxiety disorder; substance abuse disorder; obesity; chronic 8 pain; degenerative disc disease, lumbar; and posttraumatic stress disorder. Tr. 19. 9 At step three, the ALJ determined that Plaintiff does not have an impairment 10 or combination of impairments that meets or medically equal one of the listed 11 impairments in 20 C.F.R., Subpart P, Appendix 1 (20 C.F.R. §§ 404.1520(d), 12 404.1525, 404.1526, 416.920(d), 416.925 and 416.926). Tr. 20. 13 The ALJ also found that Plaintiff has the residual functional capacity 14 (“RFC”) to perform medium work, with the following limitations: 15 she can sit, stand, and walk for six hours each in an eight hour workday; 16 she is capable of simple routine task work; she can work superficially 17 and occasionally with the general public; she can work in same room with coworkers but she should not work in coordination with 18 coworkers; and she can interact occasionally with supervisors 19 Tr 22. 20 At step four, the ALJ found that Plaintiff could perform past relevant work 21 as a sorter, agricultural produce, as it is generally performed. Tr. 32-33. 22 At step five, the ALJ found that, based on the testimony of the vocational 23 expert, and considering Plaintiff’s age, education, work experience, and RFC, 24 Plaintiff also was capable of performing jobs that existed in significant numbers in 25 the national economy, including the jobs of hospital cleaner, janitor, and machine 26 packager. Tr. 34. 27 28 The ALJ thus concluded Plaintiff was not under a disability within the 1 2 meaning of the Social Security Act at any time from the alleged onset date through 3 the date of the decision. Tr. 34. 4 VI. ISSUES 5 The question presented is whether substantial evidence exists to support the 6 ALJ's decision denying benefits and, if so, whether that decision is based on proper 7 legal standards. 8 Plaintiff contends that the ALJ erred by improperly rejecting Plaintiff’s 9 symptom testimony and improperly evaluating and rejecting medical opinions by 10 Philip Gibson, David Morgan, Thomas Genthe, and Christina Eglin. 11 VII. DISCUSSION 12 A. Plaintiff’s Subjective Statements. 13 Plaintiff contends the ALJ erred by improperly rejecting her subjective 14 complaints. ECF No. 10 at 8-15. Specifically, Plaintiff complains that the ALJ 15 improperly assessed her mental health symptoms and reports of pain including 16 back pain and pain/numbness from fibromyalgia.2 It is the province of the ALJ to 17 make determinations regarding a claimant’s subjective statements. Andrews, 53 18 F.3d at 1039. However, the ALJ’s findings must be supported by specific, cogent 19 reasons. Rashad v. Sullivan, 903 F.2d 1229, 1231 (9th Cir. 1990). Once the 20 claimant produces medical evidence of an underlying medical impairment, the ALJ 21 may not discredit testimony as to the severity of an impairment merely because it 22 23 is unsupported by medical evidence. Reddick v. Chater, 157 F.3d 715, 722 (9th 24 Cir. 1998). Absent affirmative evidence of malingering, the ALJ’s reasons for 25 rejecting the claimant’s testimony must be “specific, clear and convincing.” 26

27 2 Plaintiff’s briefing specifically refers to fibromyalgia, but the ALJ found a severe 28 impairment of chronic pain syndrome, not fibromyalgia. Smolen, 80 F.3d at 1281; Lester, 81 F.3d at 834. “General findings are 1 2 insufficient: rather the ALJ must identify what testimony is not credible and what 3 evidence undermines the claimant’s complaints.” Lester at 834; Dodrill v. Shalala, 4 12 F.3d 915, 918 (9th Cir. 1993). 5 Regarding Plaintiff’s mental health issues, the ALJ examined the 6 longitudinal record, recognized some limitations, but found that the “findings and 7 observations during routine appointments does not corroborate the severity or 8 frequency of her reported symptoms and suggests greater functional capacity than 9 alleged.” Tr. 23-24. The ALJ proceeded to give specific examples from the record 10 that supported this conclusion. Tr. 23-25. Although Plaintiff points to a mis- 11 citation and complains there are also records that point to a different conclusion, 12 the mis-citation is not harmful error and the ALJ identified specific testimony and 13 specific evidence that undermined the testimony as required. 14 Further, the ALJ noted that the “severity and frequency of her mental 15 symptoms is also not entirely consistent with her treatment record.” Tr. 25. The 16 ALJ noted that despite complaints of severe symptoms, Plaintiff declined to take 17 mental health medication at several appointments. Tr. 25. Unexplained or 18 inadequately explained reasons for failing to seek medical treatment or follow a 19 prescribed course of treatment can cast doubt on a claimant’s subjective 20 complaints. Fair v. Bowen, 885 F.2d 597, 603 (9th Cir. 1989); Macri v. Chater, 93 21 F.3d 540, 544 (9th Cir. 1996) (finding the ALJ’s decision to reject the claimant’s 22 23 subjective pain testimony was supported by the fact that claimant was not taking 24 pain medication). 25 As for Plaintiff’s pain complaints, the ALJ found that record did not support 26 Plaintiff’s reports of pain both in terms of functionality when examined at 27 appointments, and Plaintiff’s disinterest in taking non-narcotic medications. 28 Tr. 25-26. Like in the case of the mental health complaints, the ALJ examined the record and cited to specific instances in the medical record that supported the 1 2 findings. Tr. 25-26. The ALJ also noted that when Plaintiff was denied narcotic 3 medications, she declined to try non-narcotic alternatives to manage pain 4 symptoms. Tr. 26. The ALJ concluded that Plaintiff would have complied with 5 treatment recommendations to address pain had the symptoms been as severe as 6 Plaintiff suggested. Tr. 26. 7 B. Medical Opinions. 8 For claims filed on or after March 27, 2017, the ALJ must consider and 9 evaluate the persuasiveness of all medical opinions or prior administrative medical 10 findings from medical sources. 20 C.F.R. § 416.920c(a) and (b), 20 C.F.R. 11 § 404.1520c(c). The factors for evaluating the persuasiveness of medical opinions 12 and prior administrative findings include supportability, consistency, the source’s 13 relationship with the claimant, any specialization of the source, and other factors 14 (such as the source’s familiarity with other evidence in the file or an understanding 15 of Social Security’s disability program). 20 C.F.R. § 416.920c(c)(1)-(5), 20 C.F.R. 16 § 404.1520c(c). 17 Supportability and consistency are the most important factors, and the ALJ 18 must explain how both factors were considered. 20 C.F.R. § 416.920c(b)(2), 20 19 C.F.R. § 404.1520c(c). The ALJ may explain how the ALJ considered the other 20 factors, but is not required to do so, except in cases where two or more opinions 21 are equally well-supported and consistent with the record. Id. Supportability and 22 23 consistency are explained in the regulations: 24 (1) Supportability. The more relevant the objective medical evidence and supporting explanations presented by a medical source are to 25 support his or her medical opinion(s) or prior administrative medical 26 finding(s), the more persuasive the medical opinions or prior administrative medical finding(s) will be. 27

28 (2) Consistency. The more consistent a medical opinion(s) or prior 1 administrative medical finding(s) is with the evidence from other 2 medical sources and nonmedical sources in the claim, the more 3 persuasive the medical opinion(s) or prior administrative medical finding(s) will be. 4 5 20 F.R. § 416.920c(c)(1)-(2) and 20 C.F.R. § 404.1520c(c). 6 The Ninth Circuit has addressed the issue of whether the regulatory 7 framework displaces the longstanding case law requiring an ALJ to provide 8 specific and legitimate reasons to reject an examining provider’s opinion. Woods 9 v. Kijakazi, 32 F.4th 785, 787 (9th Cir. 2022). The Court held that the 2017 10 regulations eliminate any hierarchy of medical opinions, and the specific and 11 legitimate standard no longer applies. Id. at 788-89, 792. The Court reasoned the 12 “relationship factors” remain relevant under the new regulations, and thus the ALJ 13 can still consider the length and purpose of the treatment relationship, the 14 frequency of examinations, the kinds and extent of examinations that the medical 15 source has performed or ordered from specialists, and whether the medical source 16 has examined the claimant or merely reviewed the claimant’s records. Id. at 790, 17 792. Even under the new regulations, an ALJ must provide an explanation 18 supported by substantial evidence when rejecting an examining or treating doctor’s 19 opinion as unsupported or inconsistent. Id. at 792. The ALJ need only examine 20 factors beyond supportability and consistency if two conflicting medical opinions 21 are “both equally well supported and consistent with the record.” 20 C.F.R. 22 § 404.1520c(b)(3). 23 Plaintiff challenges the ALJ’s assessment of four medical sources: Philip 24 Gibson; David Morgan; Thomas Genthe; and Christina Eglin. The ALJ reviewed 25 26 several conflicting medical sources and found the medical opinions of Michael 27 Brown, Ph.D., Steven Haney, M.D., Robert Stuart, M.D., and Prianka Gerrish, 28 M.D. persuasive and the opinion of Marquetta Washington, A.R.N.P. persuasive. Tr. 26-27. The ALJ found the opinions of those challenged by Plaintiff listed 1 2 above as well as Holly Petaja, Ph.D., Rana Aldaw, M.D., Myrna Palasi, M.D., 3 Brent Packer, M.D., and Russell Maier, M.D., unpersuasive. Tr. 27-32. For each 4 medical source the ALJ reviewed the supportability and consistency of the opinion. 5 Tr. 26-32. 6 1. Philip Gibson, Ph.D., David Morgan, Ph.D., and Thomas Genthe, Ph.D. 7 The ALJ examined each opinion and found that while Philip Gibson, David 8 Morgan and Thomas Genthe each had the opportunity to examine Plaintiff, none of 9 their opinions were informed by a review of the updated record and that findings of 10 11 limitations beyond “limiting the claimant to simple routine work with social 12 limitations” were out of proportion with the longitudinal record. Tr. 28. Further, 13 upon review of the medical record, the ALJ also concluded that, Plaintiff’s 14 “minimal mental health treatment record during the period at issue that suggests 15 that the claimant retains greater functional capacity than opined by” these doctors. 16 Tr. 28. As to Thomas Genthe, the ALJ also noted that his “opinion relates to an 17 administratively final adjudicated period, and it is therefore of limited relevance.” 18 Tr. 29. 19 2. Christina Eglin, M.D. 20 Finally, the ALJ reviewed treating physician Dr. Eglin’s opinion that 21 Plaintiff could not even perform sedentary work and concluded that the opinion 22 conflicted with Plaintiff’s treatment record, to include physical examinations and 23 neurological findings. Tr. 28. The ALJ concluded that Dr. Eglin’s opinion was 24 not supported by the record. Tr. 28. The ALJ properly examined Dr. Eglin’s 25 opinion for supportability, found it lacking, and thus properly found Dr. Eglin’s 26 limitations unpersuasive. 27 28 1 VIII. CONCLUSION 2 Having reviewed the record and the ALJ's findings, the Court concludes the 3|| ALJ's decision is supported by substantial evidence and is not based on harmful 4|| legal error. Accordingly, IT IS ORDERED: 5 1. Defendant’s request to affirm the Commissioner’s decision, ECF 6|| No. 15, is GRANTED. 7 2. Plaintiff's request to remand for benefits, ECF No. 10, is DENIED. 8 The District Court Executive is directed to file this Order and provide a copy 9|| to counsel. Judgment shall be entered for Defendant and the file shall be 101! CLOSED. DATED March 23, 2026.

13 LTR “GP | be ( 4 14 JAMES A. GOEKE 15 a UNITED STATES MAGISTRATE JUDGE 16 17 18 19 20 21 22 23 24 25 26 27 28