Sweeta Rahem Sultan v. Frank Bisignano, Commissioner of Social Security

Opinion

1 UNITED STATES DISTRICT COURT 2 DISTRICT OF NEVADA 3 * * *

4 SWEETA RAHEM SULTAN, Case No. 3:25-CV-00535-CLB

5 Plaintiff, ORDER DENYING PLAINTIFF’S MOTION FOR REMAND 6 v. [ECF No. 11] 7 FRANK BISIGNANO, Commissioner of Social Security, 8 9 Defendant. 10 This case involves the judicial review of an administrative action by the 11 Commissioner of Social Security (“Commissioner”) denying Sweeta Rahem Sultan’s 12 (“Sultan”) application for disability insurance benefits pursuant to Title II of the Social 13 Security Act. Currently pending before the Court is Sultan’s motion for reversal and 14 remand. (ECF No. 11.) The Commissioner filed a responsive brief, (ECF No. 13), and 15 Sultan filed a reply, (ECF No. 14). Having reviewed the pleadings, transcripts, and the 16 Administrative Record (“AR”), (ECF No. 10), the Court denies Sultan’s motion for remand. 17 (ECF No. 11.) 18 I. STANDARDS OF REVIEW 19 A. Judicial Standard of Review 20 The Court’s review of administrative decisions in social security disability benefits 21 cases is governed by 42 U.S.C. § 405(g). See Akopyan v. Barnhart, 296 F.3d 852, 854 22 (9th Cir. 2002). Section 405(g) provides that “[a]ny individual, after any final decision of 23 the Commissioner of Social Security made after a hearing to which he was a party, 24 irrespective of the amount in controversy, may obtain a review of such decision by a civil 25 action . . . brought in the district court of the United States for the judicial district in which 26 the plaintiff resides.” The court may enter, “upon the pleadings and transcript of the 27 record, a judgment affirming, modifying, or reversing the decision of the Commissioner of 1 The court must affirm an Administrative Law Judge’s (“ALJ”) determination if it is 2 based on proper legal standards and the findings are supported by substantial evidence 3 in the record. Stout v. Comm’r Soc. Sec. Admin., 454 F.3d 1050, 1052 (9th Cir. 2006); 4 see also 42 U.S.C. § 405(g) (“findings of the Commissioner of Social Security as to any 5 fact, if supported by substantial evidence, shall be conclusive”). “Substantial evidence is 6 more than a mere scintilla but less than a preponderance.” Bayliss v. Barnhart, 427 F.3d 7 1211, 1214 n.1 (9th Cir. 2005) (internal quotation marks and citation omitted). “It means 8 such relevant evidence as a reasonable mind might accept as adequate to support a 9 conclusion.” Richardson v. Perales, 402 U.S. 389, 401 (1971) (quoting Consolidated 10 Edison Co. v. NLRB, 305 U.S. 197, 229 (1938)); see also Webb v. Barnhart, 433 F.3d 11 683, 686 (9th Cir. 2005). 12 To determine whether substantial evidence exists, the court must look at the 13 administrative record as a whole, weighing both the evidence that supports and 14 undermines the ALJ’s decision. Orteza v. Shalala, 50 F.3d 748, 749 (9th Cir. 1995) 15 (citation omitted). Under the substantial evidence test, a court must uphold the 16 Commissioner’s findings if they are supported by inferences reasonably drawn from the 17 record. Batson v. Comm’r, Soc. Sec. Admin., 359 F.3d 1190, 1193 (9th Cir. 2004). 18 “However, if evidence is susceptible of more than one rational interpretation, the decision 19 of the ALJ must be upheld.” Orteza, 50 F.3d at 749 (citation omitted). The ALJ alone is 20 responsible for determining credibility and for resolving ambiguities. Meanel v. Apfel, 172 21 F.3d 1111, 1113 (9th Cir. 1999). 22 It is incumbent on the ALJ to make specific findings so that the court does not 23 speculate as to the basis of the findings when determining if substantial evidence 24 supports the Commissioner’s decision. The ALJ’s findings should be as comprehensive 25 and analytical as feasible and, where appropriate, should include a statement of 26 subordinate factual foundations on which the ultimate factual conclusions are based, so 27 that a reviewing court may know the basis for the decision. See Gonzalez v. Sullivan, 914 1 B. Standards Applicable to Disability Evaluation Process 2 The individual seeking disability benefits bears the initial burden of proving 3 disability. Roberts v. Shalala, 66 F.3d 179, 182 (9th Cir. 1995). To meet this burden, the 4 individual must demonstrate the “inability to engage in any substantial gainful activity by 5 reason of any medically determinable physical or mental impairment which can be 6 expected . . . to last for a continuous period of not less than 12 months.” 42 U.S.C. § 7 423(d)(1)(A). More specifically, the individual must provide “specific medical evidence” in 8 support of their claim for disability. See 20 C.F.R. § 404.1514. If the individual establishes 9 an inability to perform their prior work, then the burden shifts to the Commissioner to show 10 that the individual can perform other substantial gainful work that exists in the national 11 economy. Reddick v. Chater, 157 F.3d 715, 721 (9th Cir. 1998). 12 The first step requires the ALJ to determine whether the individual is currently 13 engaging in substantial gainful activity (“SGA”). 20 C.F.R. §§ 404.1520(b), 416.920(b). 14 SGA is defined as work activity that is both substantial and gainful; it involves doing 15 significant physical or mental activities, usually for pay or profit. 20 C.F.R. §§ 404.1572(a)- 16 (b), 416.972(a)-(b). If the individual is currently engaging in SGA, then a finding of not 17 disabled is made. If the individual is not engaging in SGA, then the analysis proceeds to 18 the second step. 19 The second step addresses whether the individual has a medically determinable 20 impairment that is severe or a combination of impairments that significantly limits the 21 individual from performing basic work activities. 20 C.F.R. §§ 404.1520(c), 416.920(c). 22 An impairment or combination of impairments is not severe when medical and other 23 evidence establish only a slight abnormality or a combination of slight abnormalities that 24 would have no more than a minimal effect on the individual’s ability to work. 20 C.F.R. §§ 25 404.1521, 416.921; Social Security Rulings (“SSRs”) 85-28 and 96-3p. If the individual 26 does not have a severe medically determinable impairment or combination of 27 impairments, then a finding of not disabled is made. If the individual has a severe 1 proceeds to the third step. 2 The third step requires the ALJ to determine whether the individual’s impairment 3 or combination of impairments meets or medically equals the criteria of an impairment 4 listed in 20 C.F.R. Part 404, Subpart P, Appendix 1. 20 C.F.R. §§ 404.1520(d), 404.1525, 5 404.1526, 416.920(d), 416.925, 416.926. If the individual’s impairment or combination of 6 impairments meets or equals the criteria of a listing and meets the duration requirement 7 (20 C.F.R. §§ 404.1509, 416.909), then a finding of disabled is made. 20 C.F.R. §§ 8 404.1520(h), 416.920(h). If the individual’s impairment or combination of impairments 9 does not meet or equal the criteria of a listing or meet the duration requirement, then the 10 analysis proceeds to the next step. 11 Prior to considering step four, the ALJ must first determine the individual’s residual 12 functional capacity (“RFC”). 20 C.F.R. §§ 404.1520(e), 416.920(e). The RFC is a function- 13 by-function assessment of the individual’s ability to do physical and mental work-related 14 activities on a sustained basis despite limitations from impairments. SSR 96-8p. In making 15 this finding, the ALJ must consider all the symptoms, including pain, and the extent to 16 which the symptoms can reasonably be accepted as consistent with the objective medical 17 evidence and other evidence. 20 C.F.R. §§ 404.1529 and 416.929; SSRs 96-4p, 96-7p. 18 To the extent that objective medical evidence does not substantiate statements about the 19 intensity, persistence, or functionally-limiting effects of pain or other symptoms, the ALJ 20 must make a finding on the credibility of the individual’s statements based on a 21 consideration of the entire case record. The ALJ must also consider opinion evidence in 22 accordance with the requirements of 20 C.F.R. §§ 404.1527 and 416.927 and SSRs 96- 23 2p, 96-5p, 96-6p, and 06-3p. 24 After making the RFC determination, the ALJ must then turn to step four to 25 determine whether the individual has the RFC to perform their past relevant work. 20 26 C.F.R. §§ 404.1520(f), 416.920(f). Past relevant work means work performed either as 27 the individual actually performed it or as it is generally performed in the national economy 1 addition, the work must have lasted long enough for the individual to learn the job and 2 performed at SGA. 20 C.F.R. §§ 404.1560(b), 404.1565, 416.960(b), 416.965. If the 3 individual has the RFC to perform their past work, then a finding of not disabled is made. 4 If the individual is unable to perform any past relevant work or does not have any past 5 relevant work, then the analysis proceeds to the fifth and final step. 6 The fifth and final step requires the ALJ to determine whether the individual can do 7 any other work considering their RFC, age, education, and work experience. 20 C.F.R. 8 §§ 404.1520(g), 416.920(g). If the individual can do other work, then a finding of not 9 disabled is made. Although the individual generally continues to bear the burden of 10 proving disability at this step, a limited evidentiary burden shifts to the Commissioner. The 11 Commissioner is responsible for providing evidence that demonstrates that other work 12 exists in significant numbers in the national economy that the individual can do. Lockwood 13 v. Comm’r, Soc. Sec. Admin., 616 F.3d 1068, 1071 (9th Cir. 2010). 14 II. CASE BACKGROUND 15 A. Procedural History 16 Sultan applied for disability insurance benefits (“DIB”) on June 21, 2023, with an 17 alleged disability onset date of February 8, 2023. (AR 25, 192, 196.) Sultan’s application 18 was denied initially on July 2, 2024, and upon reconsideration on April 4, 2024. (AR 188- 19 203.) Sultan subsequently requested an administrative hearing and on October 22, 2024, 20 Sultan and her attorney appeared at a telephonic hearing before an ALJ. (AR 164-86.) A 21 vocational expert (“VE”) also appeared at the hearing via telephone. (Id.) The ALJ issued 22 a written decision on October 25, 2024, finding that Sultan was not disabled because she 23 could perform other work that exists in significant numbers in the national economy. (AR 24 25-34.) Sultan appealed the October 25, 2024 decision, and the Appeals Council denied 25 review. (AR 1-4.) Accordingly, the ALJ’s decision became the final decision of the 26 Commissioner. Having exhausted all administrative remedies, Sultan filed a complaint for 27 judicial review on September 30, 2025. (See ECF No. 1.) 1 B. ALJ’s Decision 2 In the written decision, the ALJ followed the five-step sequential evaluation process 3 set forth in 20 C.F.R. §§ 404.1520 and 416.920. (AR 25-34.) Ultimately, the ALJ disagreed 4 that Sultan has been disabled from February 8, 2023, the alleged onset date, through the 5 date of his decision. (AR 37.) The ALJ held that, based on Sultan’s RFC, age, education, 6 and work experience, Sultan could perform other work that exists in significant numbers 7 in the national economy. (AR 32-33.) 8 In making this determination, the ALJ started at step one. Here, the ALJ found 9 Sultan had not engaged in substantial gainful activity since February 8, 2023, the alleged 10 onset date. (AR 27.) At step two, the ALJ found Sultan had the following severe 11 impairments: left rotator cuff arthroscopy and repair; right heel spurs; bilateral plantar 12 fasciitis; bilateral Haglund deformity; bilateral Achilles tendinitis; and bilateral knee pain. 13 (AR 28-29.) At step three, the ALJ found that through the date last insured, Sultan did not 14 have an impairment or combination of impairments that met or medically equaled the 15 severity of one of the listed impairments in 20 CFR Part 404, Subpart P, Appendix 1 (20 16 CFR 404.1520(d), 404.1525 and 404.1526). (AR 29.) 17 Next, the ALJ determined Sultan has the RFC to perform light work as defined by 18 20 CFR 404.1567(b) except: 19 Lift, carry, push or pull 20 pounds occasionally and 10 pounds frequently; stand and/or walk for about 6 hours out of 8; sit for about 6 hours out of 8; 20 frequent postural activities; no ladders, ropes, or scaffolds; frequent left 21 reaching and handling; no left overhead reaching; avoid concentrated exposure to extreme temperatures; and humidity; avoid even moderate 22 exposure to hazards.. 23 (AR 29.) 24 The ALJ found Sultan’s medically determinable impairments could reasonably be 25 expected to cause the symptoms alleged; however, Sultan’s statements concerning the 26 intensity, persistence, and limiting effects of those symptoms were inconsistent with the 27 medical evidence and other evidence in the record. (AR 30.) In reaching this conclusion, 1 factors weighing against Sultan’s credibility. (AR 29-32.) The ALJ then determined that 2 Sultan is not capable of performing past relevant work, as a store laborer, as actually or 3 generally performed. (AR 32.) 4 Relying on the testimony of the VE, the ALJ determined that Sultan’s age, 5 education, work experience, and RFC would allow him to perform other occupations 6 existing in significant numbers in the national economy, such as: inspector and hand 7 packager, assembler of small products, and assembler of electronic accessories. (AR 8 33.) Accordingly, the ALJ held that Sultan had not been under a disability disabled from 9 February 8, 2023, the alleged onset date, through the date of his decision, and denied 10 Sultan’s claim. (AR 33-34.) 11 III. ISSUE 12 Sultan seeks judicial review of the Commissioner’s final decision denying DIB 13 under Title II of the Social Security Act. (ECF No. 11.) Sultan raises a single issue for the 14 Court’s review: Whether the ALJ provided clear and convincing reasons for rejecting 15 Sultan’s subjective symptom testimony. (Id. at 5-10.) 16 IV. DISCUSSION 17 When determining a claimant’s RFC, the ALJ must consider all the symptoms, 18 including pain, and the extent to which the symptoms can reasonably be accepted as 19 consistent with the objective medical evidence and other evidence. 20 C.F.R. §§ 20 404.1529 and 416.929; SSRs 96-4p, 96-7p. “[T]he ALJ ‘is responsible for determining 21 credibility, resolving conflicts in medical testimony, and for resolving ambiguities.’” Ford, 22 950 F.3d at 1149 (quoting Andrews v. Shalala, 53 F.3d 1035, 1039 (9th Cir. 1995)). “In 23 evaluating the credibility of a claimant’s testimony regarding subjective pain, an ALJ must 24 engage in a two-step analysis.” Vasquez v. Astrue, 572 F.3d 586, 591 (9th Cir. 2009); 25 see also Leon v. Berryhill, 880 F.3d 1041, 1046 (9th Cir. 2018) (as amended); Diedrich v. 26 Berryhill, 874 F.3d 634, 641 (9th Cir. 2017); Molina v. Astrue, 674 F.3d 1104, 1112 (9th 27 Cir. 2012), superseded on other grounds by 20 C.F.R. § 404.1502(a). “First, the ALJ must 1 underlying impairment which could reasonably be expected to produce the pain or other 2 symptoms alleged.” Lingenfelter v. Astrue, 504 F.3d 1028, 1036 (9th Cir. 2007) (internal 3 quotation marks and citation omitted); Smith v. Kijakazi, 14 F.4th 1108, 1111 (9th Cir. 4 2021) (quoting Garrison v. Colvin, 759 F.3d 995, 1014 (9th Cir. 2014); see also Coleman 5 v. Saul, 979 F.3d 751, 756 (9th Cir. 2020) (“An ALJ, however, may not discredit the 6 claimant’s subjective complaints solely because the objective evidence fails to fully 7 corroborate the degree of pain alleged.” (citing Reddick, 157 F.3d at 722)). 8 “Second, if the claimant meets this first test, and there is no evidence of 9 malingering, the ALJ can reject the claimant’s testimony about the severity of her 10 symptoms only by offering specific, clear and convincing reasons for doing so.” 11 Lingenfelter, 504 F.3d at 1036 (internal quotation marks and citation omitted). “General 12 findings are insufficient; rather, the ALJ must identify what testimony is not credible and 13 what evidence undermines the claimant’s complaints.” Berry v. Astrue, 622 F.3d 1228, 14 1234 (9th Cir. 2010) (internal quotation marks and citation omitted); see also Smith, 14 15 F.4th at 1113 (“In other words, to reject the specific portions of the claimant’s testimony 16 that the ALJ has found not to be credible, we require that the ALJ provide clear and 17 convincing reasons relevant to that portion.” (internal citations omitted)). 18 In weighing a claimant’s credibility, the ALJ may consider their reputation for 19 truthfulness; inconsistencies either in their testimony or between their testimony and their 20 conduct; their daily activities; work record; and testimony from physicians and third parties 21 concerning the nature, severity, and effect of the symptoms of which they complain. See 22 Smolen v. Chater, 80 F.3d 1273, 1284 (9th Cir. 1996) (citations omitted); see Rounds v. 23 Comm’r Soc. Sec. Admin., 807 F.3d 996, 1006 (9th Cir. 2015) (as amended) (to assess 24 credibility the ALJ “may consider, among other factors, ‘ordinary techniques of credibility 25 evaluation,’ ‘inadequately explained failure to seek treatment or to follow a prescribed 26 course of treatment,’ and ‘the claimant’s daily activities.’ ” (citation omitted)). 27 The ALJ’s decision states that in formulating Sultan’s RFC, the ALJ “considered 1 consistent with the objective medical evidence and other evidence, based on the 2 requirements of 20 CFR 404.1529 and SSR 16-3p.” (AR 29.) The ALJ first described 3 Sultan’s subjective symptom testimony as follows: 4 The claimant testified that she is 49 years-old and lives with her daughter and son. She is currently not working. She previously worked at Arrow 5 Electronics as a warehouse associate and stopped working in February 2023 because she had a lot of pain in her shoulder. She had surgery in April 6 2023 but after the surgery, she still had pain. She cannot raise her arm and has pain in her shoulder and neck. She cannot raise her left arm above her 7 head. She cannot sit too long because of her back pain. She can stand for 5 or 6 minutes until she has to sit down. She has a lot of pain coming from 8 both feet. Per the claimant’s Function Report, she reported problems with lifting, squatting, standing, reaching, walking, sitting, kneeling, and stair 9 climbing [(AR 424)]. 10 (AR 30.) 11 After summarizing Sultan’s subjective symptom testimony, the ALJ explained that 12 “[t]he medical record demonstrates lesser severity of functionally limiting symptoms than 13 as alleged by the claimant.” (AR 30.) The ALJ then discussed the medical evidence in the 14 record for each of Sultan’s impairments. (AR 30-31.) For Sultan’s shoulder, the ALJ noted 15 that after Sultan underwent surgery, she received physical therapy and reported that her 16 lingering pain was improving and was permitted to return to all regular activities as pain 17 tolerated. (AR 30 (citing AR 561, 976).) For Sultan’s bilateral Achilles tendinitis and 18 bilateral plantar fasciitis, the ALJ noted that she was evaluated and received treatment in 19 the form of physical therapy as well as icing, stretching, inserts, and pain medications. 20 (AR 30-31 (citing AR 548, 922, 929, 936; 961, 1101-2.)) Finally, the ALJ addressed 21 Sultan’s bilateral knee pain, noting imaging studies of both knees were normal and she 22 received injections and physical therapy. (AR 31 (citing AR 535-36, 1115).) 23 After so doing, the ALJ included restrictions in Sultan’s RFC to account for her 24 reported residual pain and symptoms. (Id.) Regarding Sultan’s shoulder, the ALJ included 25 a restriction for “no frequent left reaching and handling; no left overhead reaching.” (Id.) 26 For Sultan’s bilateral Achilles tendinitis, bilateral plantar fasciitis, and bilateral knee pain, 27 the ALJ included a restriction for “less than light work, frequent postural activities and no 1 Finally, the ALJ explained: 2 Overall, with respect to the claimant’s impairments, the medical record demonstrates conservative primary care treatment at without evidence of 3 significant changes in objective medical findings or treatment recommendations [(AR 922, 961, 1101-2, 1115)]. Despite receiving routine 4 treatments for her symptoms, particularly with respect to the shoulder, the medical record, as discussed above, shows that such treatments were 5 primarily conservative in nature, often in the form of recommendations for physical therapy, in-home exercises, follow-up visits and continuation with 6 or adjustments to medications. The record as a whole establishes that the claimant’s impairments cause some limitations in the claimant’s ability to 7 perform basic, work-related activities; however, those limitations are accounted for in the residual functional capacity assessment set forth 8 above, which is supported by objective medical findings. 9 (Id.) 10 In her motion for remand, Sultan argues the ALJ erred in discounting her subjective 11 symptom testimony because: (1) the ALJ merely recited the medical evidence in support 12 of Sultan’s RFC, rather than providing specific, clear, and convincing reasons for rejecting 13 her testimony; (2) the ALJ mischaracterized whether Sultan’s conditions were improving; 14 and (3) the ALJ improperly relied on evidence of conservative treatment to discount her 15 subjective symptom testimony because the record does not support that more aggressive 16 treatment was recommended or available. (ECF No. 11 at 5-10.) 17 1. Consistency with Medical Evidence 18 Sultan first argues the ALJ erred because he merely recited the medical evidence 19 in support of Sultan’s RFC, rather than providing specific, clear, and convincing reasons 20 for why the objective medical evidence discounts Sultan’s testimony. (ECF No. 11 at 7.) 21 An ALJ may not “reject a claimant’s subjective complaints based solely on a lack of 22 medical evidence to fully corroborate the alleged severity of pain.” Burch v. Barnhart, 400 23 F.3d 676, 681 (9th Cir. 2005). This means an ALJ cannot effectively render a claimant’s 24 subjective symptom testimony superfluous by demanding positive objective medical 25 evidence “fully corroborat[ing]” every allegation within the subjective testimony. Smartt v. 26 Kijakazi, 53 F.4th 489, 498 (9th Cir. 2022) (citations omitted). 27 However, the Ninth Circuit has repeatedly upheld ALJ decisions where the ALJ 1 subjective testimony, the ALJ may indeed weigh it as undercutting such testimony.” 2 Smartt, 53 F.4th at 498 (emphasis original) (citing Chaudhry v. Astrue, 688 F.3d 661, 672- 3 73 (9th Cir. 2012) (affirming an ALJ’s determination that interpreted and preferred 4 objective medical evidence to subjective testimony); Burch, 400 F.3d at 681 (affirming an 5 ALJ’s discounting of subjective claims of disabling pain based on objective medical 6 evidence and a claimant’s daily activities); Thomas v. Barnhart, 278 F.3d 947, 959 (9th 7 Cir. 2002) (affirming an ALJ’s decision discounting a claimant’s testimony after “finding 8 no objective medical evidence to support [claimant’s] descriptions of her pain and 9 limitations,” and “that [claimant] was able to perform various household chores such as 10 cooking, laundry, washing dishes, and shopping”); Osenbrock v. Apfel, 240 F.3d 1157, 11 1165-66 (9th Cir. 2001) (affirming an ALJ’s rejection of allegations of disabling pain based 12 on normal physical examinations)). An ALJ does not commit error by “relying on any 13 contradictions between a claimant’s subjective symptom testimony and the objective 14 medical evidence in the record to discount the symptom testimony.” Id. at n.1 (emphasis 15 original). 16 As outlined above, the ALJ discussed Sultan’s testimony regarding her physical 17 limitations, including that Sultan has pain in her shoulder, neck, back, and both feet, 18 cannot raise her left arm above her head, cannot sit for too long without pain, can stand 19 for 5 or 6 minutes before sitting, and has problems with lifting, squatting, standing, 20 reaching, walking, sitting, kneeling, and stair climbing. (AR 30.) The ALJ then discussed 21 the medical evidence showing that Sultan’s shoulder pain improved after surgery and that 22 the treatment recommendations for her knees and feet were for physical therapy, knee 23 injections, icing, stretching, inserts, and pain medications. (AR 30-31 (citing AR 535-36, 24 548, 561, 922, 929, 936, 961, 976, 1101-2, 1115).) The ALJ then explained “[o]verall, with 25 respect to the claimant’s impairments, the medical record demonstrates conservative 26 primary care treatment at without evidence of significant changes in objective medical 27 findings or treatment recommendations”. (AR 301 (citing AR 922, 961, 1101-2, 1115).) 1 subjective symptom testimony by identifying specific testimony that was inconsistent with 2 specific medical evidence. Berry, 622 F.3d at 1234 (citation omitted); see Smith, 14 F.4th 3 at 1113. Although the medical evidence could be interpreted in a different manner, the 4 Court “may not substitute our judgment for that of the [ALJ].” Garrison, 759 F.3d at 1010 5 (citing Andrews, 53 F.3d at 1039); Orteza, 50 F.3d at 749 (“if evidence is susceptible of 6 more than one rational interpretation, the decision of the ALJ must be upheld.”). 7 Additionally, as explained above, although the ALJ found “[t]he medical record 8 demonstrates lesser severity of functionally limiting symptoms than as alleged by the 9 claimant[,]” the ALJ did include restrictions in Sultan’s RFC to account for her reported 10 pain. The ALJ included restrictions of “no frequent left reaching and handling; no left 11 overhead reaching” for Sultan’s shoulder pain and “less than light work, frequent postural 12 activities and no ladders, ropes or scaffolds” for her feet and knee pain. (AR 30-31.) Thus, 13 it is clear the ALJ did not wholly reject Sultan’s subjective symptom testimony but rather 14 permissibly weighed the medical evidence as undercutting Sultan’s testimony. Smartt, 15 F.4th at 498. Further, as discussed below, the ALJ’s credibility determination was also 16 supported by evidence that Sultan only conservatively treated her impairments. 17 See Buckner-Larkin v. Astrue, 450 F. App'x 626, 628 (9th Cir. 2011) (finding “the ALJ 18 pointed to clear, specific, and cogent reasons” for discounting the claimant’s subjective 19 complaints where the ALJ pointed to “inconsistencies between her complaints and 20 medical evidence, her daily activities, and the success of conservative treatment.”). 21 Therefore, the Court finds that the ALJ did not err in finding that Sultan’s subjective 22 symptom testimony conflicted with the medical evidence in the record. Id. 23 2. Conservative Treatment and Improvement 24 The Court will now address Sultan’s final two arguments. Sultan argues the ALJ 25 mischaracterized whether Sultan’s conditions were improving and erred in relying on 26 evidence of conservative treatment to discount her subjective symptom testimony 27 because the record does not support that more aggressive treatment was recommended 1 discount a claimant’s testimony regarding severity of an impairment. Parra v. Astrue, 481 2 F.3d 742, 751 (9th Cir. 2007) (citing Johnson v. Shalala, 60 F.3d 1428, 1434 (9th Cir. 3 1995)) (finding “evidence of ‘conservative treatment’ is sufficient to discount a claimant’s 4 testimony regarding severity of an impairment”). The type and degree of treatment a 5 claimant seeks “is powerful evidence” regarding the extent of symptoms. Burch v. 6 Barnhart, 400 F.3d 676, 681 (9th Cir. 2005). The amount of treatment is “an important 7 indicator of the intensity and persistence of [a claimant’s] symptoms.” 20 C.F.R. § 8 404.1529(c)(3); Warre v. Comm’r of Soc. Sec. Admin., 439 F.3d 1001, 1006 (9th Cir. 9 2006) (determining that conditions effectively controlled with medication are not disabling 10 for purposes of determining eligibility for benefits); Tommasetti v. Astrue, 533 F.3d 1035, 11 1040 (9th Cir. 2008) (recognizing that a favorable response to treatment can undermine 12 a claimant’s complaints of debilitating pain or other severe limitations). Claims about 13 disabling pain are undermined by favorable response to conservative treatment. 14 Tommasetti, 533 F.3d at 1039-1040. However, “[a] claimant cannot be discredited for 15 failing to pursue non-conservative treatment options where none exist,” Lapeirre-Gutt v. 16 Astrue, 382 Fed.Appx. 662, 664 (9th Cir. 2010), or where the claimant has a good reason 17 for not seeking more aggressive treatment. Carmickle v. Comm’r, Soc. Sec. Admin., 533 18 F.3d 1155, 1162 (9th Cir. 2008) (citing Orn v. Astrue, 495 F.3d 625, 638 (9th Cir. 2007)). 19 Sultan argues the ALJ “cannot claim that [Sultan’s] treatment was ‘conservative’ 20 while also pointing to surgery as proof that symptoms improved.” (ECF No. 14 at 5.) The 21 Ninth Circuit examined a similar argument in Smartt v. Kijakazi, where the claimant 22 argued that her cervical spine surgery was not conservative treatment. 53 F.4th at 500. 23 In Smartt, the Ninth Circuit found that the ALJ’s decision was supported by specific, clear, 24 and convincing findings with substantial evidence in the record where the ALJ noted that 25 after the claimant underwent surgery, she received conservative treatment, “including 26 physical therapy, temporary use of a neck brace and wheelchair, and ongoing pain 27 medication.” Id. The Ninth Circuit noted that “[a]s a result of these measures, the record 1 not err in concluding that such ongoing conservative treatment and overall improvement 2 are inconsistent with [the claimant’s] testimony as to the severity of her impairments.” Id. 3 In this case, the ALJ noted in his decision that medical record shows that after 4 Sultan’s surgery,1 she received conservative treatment recommendations for “physical 5 therapy, in-home exercises, follow-up visits and continuation with or adjustments to 6 medications.” (AR 31.) There is no evidence in the record showing that medical providers 7 recommended more aggressive treatment options. Thus, as in Smartt, the record 8 demonstrates both self-reported and objective improvement based on the conservative 9 treatment recommendations. Furthermore, as explained above, the ALJ did not 10 completely reject Sultan’s subjective symptom testimony and included restrictions in 11 Sultan’s RFC based on her reported residual pain and symptoms. Finally, even where the 12 medical evidence could support another interpretation, the Court “may not substitute our 13 judgment for that of the [ALJ].” Garrison, 759 F.3d at 1010 (citing Andrews, 53 F.3d at 14 1039); Orteza, 50 F.3d at 749. Therefore, the ALJ did not err in concluding that ongoing 15 conservative treatment and overall improvement were inconsistent with Sultan’s 16 testimony as to the severity of her impairments. Smartt, 53 F.4th at 500. 17 In conclusion, the Court finds that the ALJ’s evaluation of Sultan’s subjective 18 symptom testimony is supported by substantial evidence in the record because the ALJ 19 properly relied on specific reasons for discounting Sultan’s allegations by pointing to 20 inconsistencies between her complaints and medical evidence and her conservative 21 treatment. See Buckner-Larkin, 450 F. App’x at 628; Smartt, 53 F.4th at 500. 22 V. CONCLUSION 23 Having reviewed the Administrative Record as a whole, and weighing the evidence 24 that supports and detracts from the Commissioner’s conclusion, the Court finds the ALJ’s 25 decision was supported by substantial evidence and is free of legal error. 26 1 In his decision, the ALJ states that Sultan underwent shoulder surgery on April 4, 2024. (AR 30.) However, the medical records show that the surgery occurred one 27 year earlier, on April 4, 2023. (AR 549.) Regardless, the decision itself makes clear that the ALJ understood the surgery to have taken place in 2023. (AR 30 (“At the end of 2023, 1 Accordingly, IT IS THEREFORE ORDERED that Sultan’s motion to remand, (ECF 2| No. 11), is DENIED, and the final decision of the Commissioner is AFFIRMED. 3 IT IS FURTHER ORDERED that the Clerk ENTER JUDGMENT and CLOSE THIS 4| CASE. 5 DATED: April 3, 2026. < » 6 7 UNITED STATES\MAGISTRATE JUDGE 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 25 26 27 28 4K