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5 6 7 UNITED STATES DISTRICT COURT 8 WESTERN DISTRICT OF WASHINGTON AT TACOMA 9 10 JEANIE L. T., CASE NO. 3:24-CV-5963-DWC 11 Plaintiff, v. ORDER RE: SOCIAL SECURITY 12 DISABILITY APPEAL COMMISSIONER OF SOCIAL 13 SECURITY, 14 Defendant.
15 Plaintiff filed this action pursuant to 42 U.S.C. § 405(g) for judicial review of the denial 16 of her application for Supplemental Security Income (SSI) benefits. Pursuant to 28 U.S.C. § 17 636(c), Fed. R. Civ. P. 73, and Local Rule MJR 13, the parties have consented to proceed before 18 the undersigned. After considering the record, the Court finds no reversible error and affirms the 19 Commissioner’s decision to deny benefits. 20 I. BACKGROUND 21 Plaintiff filed applied for SSI on April 27, 2023. Administrative Record (AR) 17. Her 22 alleged date of disability onset is December 31, 2022. Id. Her requested hearing was held before 23 an Administrative Law Judge (ALJ) on June 27, 2024. AR 34–63. On July 17, 2024, the ALJ 24 1 issued a written decision finding Plaintiff not disabled. AR 14–33. The Appeals Council declined 2 Plaintiff’s timely request for review, making the ALJ’s decision the final agency action subject 3 to judicial review. AR 1–6. On November 22, 2024, Plaintiff filed a Complaint in this Court 4 seeking judicial review of the ALJ’s decision. Dkt. 4.
5 II. STANDARD 6 Pursuant to 42 U.S.C. § 405(g), this Court may set aside the Commissioner’s denial of 7 benefits if, and only if, the ALJ’s findings are based on legal error or not supported by 8 substantial evidence in the record as a whole. Bayliss v. Barnhart, 427 F.3d 1211, 1214 n.1 (9th 9 Cir. 2005) (citing Tidwell v. Apfel, 161 F.3d 599, 601 (9th Cir. 1999)). 10 III. DISCUSSION 11 In her opening brief, Plaintiff contends the ALJ failed to properly consider the medical 12 opinions of Matthew Chance, NP, and David Morgan, PhD. Dkt. 12. 13 For applications, like Plaintiff's, filed after March 27, 2017, ALJs need not “defer or give 14 any specific evidentiary weight, including controlling weight, to” particular medical opinions,
15 including those of treating or examining sources. See 20 C.F.R. §§ 404.1520c(a), 416.920c(a). 16 Rather, ALJs must consider every medical opinion in the record and evaluate each opinion's 17 persuasiveness, considering each opinion's “supportability” and “consistency,” and, under some 18 circumstances, other factors. Woods v. Kijakazi, 32 F.4th 785, 791 (9th Cir. 2022); 20 C.F.R. §§ 19 404.1520c(b)–(c), 416.920c(b)–(c). Supportability concerns how a medical source supports a 20 medical opinion with relevant evidence, while consistency concerns how a medical opinion is 21 consistent with other evidence from medical and nonmedical sources. 20 C.F.R. §§ 22 404.1520c(c)(1), (c)(2); 416.920c(c)(1), (c)(2). 23
24 1 A. NP Chance 2 Treating provider NP Chance completed an opinion in June 2024. AR 937–38. Aside 3 from deferring to his opinion that Plaintiff was limited to light work, the ALJ found the opinion 4 unpersuasive. See AR 25–26. The ALJ gave sufficient reasons for doing so.
5 NP Chance opined Plaintiff was limited to less-than-occasional handling with both 6 extremities. AR 1938. The ALJ found this “excessive compared to the imaging findings of mild 7 to moderate arthritic changes, with the physical examinations showing some mild swelling at 8 times, but otherwise full strength, range of motion, and normal gait.” AR 25. 9 The ALJ reasonably found the less-than-occasional handling limitation inconsistent with 10 the medical evidence. As the ALJ noted (AR 23), the only relevant imaging in the record 11 involved a 2023 x-ray that showed mild-to-moderate arthritic changes in Plaintiff’s right hand 12 (which appears several times in the record, see AR 635, 751, 1675–77). This does little to 13 explain why Plaintiff would have handling limitations in her left upper extremity, and the ALJ 14 reasonably found notations of Plaintiff’s arthritic changes as being mild-to-moderate were
15 inconsistent with less-than-occasional handling with her right extremity. 16 The ALJ could also find the physical examinations inconsistent with the handling 17 limitation. As the ALJ discussed, some appointments found Plaintiff had mild swelling (see AR 18 642, 1681) but others noted no swelling in Plaintiff’s upper extremities (see AR 667, 800, 1791, 19 1809–10). A few examinations noted swelling in specific fingers (see AR 705, 918) but handling 20 involves “working primarily with the whole hand” rather than specific fingers (see SSR 85-15). 21 The ALJ could reasonably find the mostly normal physical examinations and few notations of 22 mild swelling inconsistent with the less-than-occasional handling limitation. 23
24 1 While Plaintiff argues the ALJ’s consistency finding was erroneous because it ignored 2 that another treating source, Jessica Dibari, DO, noted “arthritis causes joint pain” (see Dkt. 12 at 3 5, AR 532), Dr. Dibari opined Plaintiff would have no limitations in handling involving her 4 upper extremities (see AR 533). This does not support Plaintiff’s contention.
5 NP Chance also opined Plaintiff would, “on average,” miss four or more days per month 6 because “in the past she has had to miss as much as 1.5 weeks of work.” AR 1937. The ALJ 7 properly found this explanation did not support the opined limitation. See AR 25. The extent to 8 which Plaintiff missed work at one point in the past does not suggest the average amount she 9 would miss work in the future. 10 Finally, NP Chance opined Plaintiff would “sometimes” have to elevate her legs. AR 11 1937. The ALJ properly found this was a vague limitation and discounted it accordingly. See AR 12 25; Ford v. Saul, 950 F.3d 1141, 1156 (9th Cir. 2020) (upholding ALJ determination that 13 descriptions “were not useful because they failed to specify Ford’s functional limits,” from 14 which “the ALJ could reasonably conclude [those limitations] were inadequate for determining
15 RFC”). NP Chance’s comment that Plaintiff’s knee pain worsens with standing and stiffens with 16 sitting (AR 1937) was a statement about the severity of Plaintiff’s symptoms rather than a 17 portion of his medical opinion (see 20 C.F.R. § 404.1513(a)(2)–(3)) and, nonetheless, would 18 have been factored into NP Chance’s opinion that Plaintiff could perform light work, which the 19 ALJ accepted. 20 Plaintiff also contends the ALJ erred by failing to address the supportability factor (Dkt. 21 12 at 5–6), but this is, at best, harmless error. See Woods, 32 F.4th at 792–93 (finding proper 22 consideration of one of supportability-and-consistency factors to be adequate basis to affirm); 23 Stout v. Comm’r, Soc. Sec.
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5 6 7 UNITED STATES DISTRICT COURT 8 WESTERN DISTRICT OF WASHINGTON AT TACOMA 9 10 JEANIE L. T., CASE NO. 3:24-CV-5963-DWC 11 Plaintiff, v. ORDER RE: SOCIAL SECURITY 12 DISABILITY APPEAL COMMISSIONER OF SOCIAL 13 SECURITY, 14 Defendant.
15 Plaintiff filed this action pursuant to 42 U.S.C. § 405(g) for judicial review of the denial 16 of her application for Supplemental Security Income (SSI) benefits. Pursuant to 28 U.S.C. § 17 636(c), Fed. R. Civ. P. 73, and Local Rule MJR 13, the parties have consented to proceed before 18 the undersigned. After considering the record, the Court finds no reversible error and affirms the 19 Commissioner’s decision to deny benefits. 20 I. BACKGROUND 21 Plaintiff filed applied for SSI on April 27, 2023. Administrative Record (AR) 17. Her 22 alleged date of disability onset is December 31, 2022. Id. Her requested hearing was held before 23 an Administrative Law Judge (ALJ) on June 27, 2024. AR 34–63. On July 17, 2024, the ALJ 24 1 issued a written decision finding Plaintiff not disabled. AR 14–33. The Appeals Council declined 2 Plaintiff’s timely request for review, making the ALJ’s decision the final agency action subject 3 to judicial review. AR 1–6. On November 22, 2024, Plaintiff filed a Complaint in this Court 4 seeking judicial review of the ALJ’s decision. Dkt. 4.
5 II. STANDARD 6 Pursuant to 42 U.S.C. § 405(g), this Court may set aside the Commissioner’s denial of 7 benefits if, and only if, the ALJ’s findings are based on legal error or not supported by 8 substantial evidence in the record as a whole. Bayliss v. Barnhart, 427 F.3d 1211, 1214 n.1 (9th 9 Cir. 2005) (citing Tidwell v. Apfel, 161 F.3d 599, 601 (9th Cir. 1999)). 10 III. DISCUSSION 11 In her opening brief, Plaintiff contends the ALJ failed to properly consider the medical 12 opinions of Matthew Chance, NP, and David Morgan, PhD. Dkt. 12. 13 For applications, like Plaintiff's, filed after March 27, 2017, ALJs need not “defer or give 14 any specific evidentiary weight, including controlling weight, to” particular medical opinions,
15 including those of treating or examining sources. See 20 C.F.R. §§ 404.1520c(a), 416.920c(a). 16 Rather, ALJs must consider every medical opinion in the record and evaluate each opinion's 17 persuasiveness, considering each opinion's “supportability” and “consistency,” and, under some 18 circumstances, other factors. Woods v. Kijakazi, 32 F.4th 785, 791 (9th Cir. 2022); 20 C.F.R. §§ 19 404.1520c(b)–(c), 416.920c(b)–(c). Supportability concerns how a medical source supports a 20 medical opinion with relevant evidence, while consistency concerns how a medical opinion is 21 consistent with other evidence from medical and nonmedical sources. 20 C.F.R. §§ 22 404.1520c(c)(1), (c)(2); 416.920c(c)(1), (c)(2). 23
24 1 A. NP Chance 2 Treating provider NP Chance completed an opinion in June 2024. AR 937–38. Aside 3 from deferring to his opinion that Plaintiff was limited to light work, the ALJ found the opinion 4 unpersuasive. See AR 25–26. The ALJ gave sufficient reasons for doing so.
5 NP Chance opined Plaintiff was limited to less-than-occasional handling with both 6 extremities. AR 1938. The ALJ found this “excessive compared to the imaging findings of mild 7 to moderate arthritic changes, with the physical examinations showing some mild swelling at 8 times, but otherwise full strength, range of motion, and normal gait.” AR 25. 9 The ALJ reasonably found the less-than-occasional handling limitation inconsistent with 10 the medical evidence. As the ALJ noted (AR 23), the only relevant imaging in the record 11 involved a 2023 x-ray that showed mild-to-moderate arthritic changes in Plaintiff’s right hand 12 (which appears several times in the record, see AR 635, 751, 1675–77). This does little to 13 explain why Plaintiff would have handling limitations in her left upper extremity, and the ALJ 14 reasonably found notations of Plaintiff’s arthritic changes as being mild-to-moderate were
15 inconsistent with less-than-occasional handling with her right extremity. 16 The ALJ could also find the physical examinations inconsistent with the handling 17 limitation. As the ALJ discussed, some appointments found Plaintiff had mild swelling (see AR 18 642, 1681) but others noted no swelling in Plaintiff’s upper extremities (see AR 667, 800, 1791, 19 1809–10). A few examinations noted swelling in specific fingers (see AR 705, 918) but handling 20 involves “working primarily with the whole hand” rather than specific fingers (see SSR 85-15). 21 The ALJ could reasonably find the mostly normal physical examinations and few notations of 22 mild swelling inconsistent with the less-than-occasional handling limitation. 23
24 1 While Plaintiff argues the ALJ’s consistency finding was erroneous because it ignored 2 that another treating source, Jessica Dibari, DO, noted “arthritis causes joint pain” (see Dkt. 12 at 3 5, AR 532), Dr. Dibari opined Plaintiff would have no limitations in handling involving her 4 upper extremities (see AR 533). This does not support Plaintiff’s contention.
5 NP Chance also opined Plaintiff would, “on average,” miss four or more days per month 6 because “in the past she has had to miss as much as 1.5 weeks of work.” AR 1937. The ALJ 7 properly found this explanation did not support the opined limitation. See AR 25. The extent to 8 which Plaintiff missed work at one point in the past does not suggest the average amount she 9 would miss work in the future. 10 Finally, NP Chance opined Plaintiff would “sometimes” have to elevate her legs. AR 11 1937. The ALJ properly found this was a vague limitation and discounted it accordingly. See AR 12 25; Ford v. Saul, 950 F.3d 1141, 1156 (9th Cir. 2020) (upholding ALJ determination that 13 descriptions “were not useful because they failed to specify Ford’s functional limits,” from 14 which “the ALJ could reasonably conclude [those limitations] were inadequate for determining
15 RFC”). NP Chance’s comment that Plaintiff’s knee pain worsens with standing and stiffens with 16 sitting (AR 1937) was a statement about the severity of Plaintiff’s symptoms rather than a 17 portion of his medical opinion (see 20 C.F.R. § 404.1513(a)(2)–(3)) and, nonetheless, would 18 have been factored into NP Chance’s opinion that Plaintiff could perform light work, which the 19 ALJ accepted. 20 Plaintiff also contends the ALJ erred by failing to address the supportability factor (Dkt. 21 12 at 5–6), but this is, at best, harmless error. See Woods, 32 F.4th at 792–93 (finding proper 22 consideration of one of supportability-and-consistency factors to be adequate basis to affirm); 23 Stout v. Comm’r, Soc. Sec. Admin., 454 F.3d 1050, 1054 (9th Cir. 2006) (error inconsequential to
24 1 non-disability determination is harmless). The ALJ did not reversibly err in considering NP 2 Chance’s opinion. 3 B. Dr. Morgan 4 Consulting examiner Dr. Morgan completed an opinion in June 2023. AR 729–33. He
5 opined Plaintiff had marked limitations in most work-related abilities, including her abilities to 6 perform activities in a schedule, adapt to changes, make simple decisions, ask simple questions, 7 communicate and perform effectively, and maintain appropriate behavior. See AR 731. 8 The ALJ found Dr. Morgan’s opinion unpersuasive, relying upon a medical opinion 9 submitted by Michael Jenkins-Guarnieri, MD. See AR 27. Dr. Jenkins-Guarnieri completed a 10 Review of Medical Evidence form for the Washington State Department of Social and Health 11 Services (DSHS) wherein he discussed Dr. Morgan’s findings. AR 761–63. He reviewed the 12 medical evidence, describing evidence of malingering, evidence that situational stressors 13 exacerbated her symptoms, and Plaintiff’s background and work history. See id. Based on this 14 evidence, he recommended Dr. Morgan’s opinion be modified to include only mild and moderate
15 limitations and indicated Plaintiff’s mental conditions were unlikely to last more than ten months 16 with proper treatment. AR 762. The ALJ found Dr. Jenkins-Guarnieri’s opinion persuasive and 17 relied upon its rationale in discounting Dr. Morgan’s opinion. See AR 27. 18 This was a proper basis on which to reject the opinion. A medical opinion may be 19 properly discounted based on an inadequate perception of a claimant’s conditions at the time it 20 was rendered. See Chaudhry v. Astrue, 688 F.3d 661, 671 (9th Cir. 2012) (ALJ properly 21 discounted sources based on mistaken or inadequate view of record). The evidence discussed by 22 Dr. Jenkins-Guarnieri cast substantial doubt on Dr. Morgan’s opinion. Evidence of malingering 23 suggests Plaintiff’s reported history was unreliable. See id. Evidence of situational stressors
24 1 suggests Plaintiff’s symptoms had causes other than her impairments. See 20 C.F.R. § 404.1545 2 (RFC incorporates only limitations from impairments). 3 Plaintiff’s sole argument to the contrary is that the ALJ’s reliance upon Dr. Jenkins- 4 Guarnieri’s opinion violated 20 C.F.R. § 416.904 (Dkt. 12 at 10–11), under which “decision[s]
5 by any other government agency . . . about whether [a claimant is] disabled” are not binding and 6 require no analysis. However, Dr. Jenkins-Guarnieri’s opinion was not a decision as to whether 7 Plaintiff was disabled. The form he submitted was not dispositive in any of DSHS’s disability 8 decisions, nor did it call for his opinion as to whether Plaintiff was disabled. See id. Rather, it 9 was a “review of the medical evidence.” AR 761. The Commissioner can consider “supporting 10 evidence,” such as a medical opinion, “underlying” the decision of another government entity. 11 See 20 C.F.R. § 416.904.1 Indeed, if § 416.904 bars consideration of Dr. Jenkins-Guarnieri’s 12 opinion, then it would also bar consideration of Dr. Morgan’s evaluation (completed on contract 13 with DSHS). See AR 729–34. The ALJ properly relied upon Dr. Jenkins-Guarnieri’s opinion. 14 Having found the ALJ provided proper reasons for rejecting Dr. Morgan’s opinion, the
15 Court need not consider the ALJ’s remaining reasons as any error with respect to those reasons 16 would be harmless. See Stout, 454 F.3d at 1054–56. 17 Furthermore, the ALJ properly found Dr. Jenkins-Guarnieri’s opinion more persuasive 18 than Dr. Morgan’s because Dr. Morgan “was more vague in his record review.” AR 26–27; 20 19 C.F.R. §§ 404.1520c(b)(3), (c)(5) (ALJ can find an opinion more persuasive than another based 20
21 1 Both cases relied upon by Plaintiff in her Reply Brief (Dkt. 15 at 3–4) are distinguishable. Darrel M. v. Saul, 2019 WL 10301640 at *13 (W.D. Wash. Nov. 14, 2019), involved “a State court decision finding plaintiff entitled to 22 ABDA benefits,” which is readily described as a “decision by [another] government agency” on whether she is disabled, 20 C.F.R. § 416.904. Russell S. v. Commissioner of Social Security, 2021 WL 5162009 at *3 (W.D. Wash., 23 2021), involved an ALJ who noted a state agency opinion was based on state agency rules, but the Court did not suggest this was proper or improper, instead considering the ALJ’s remaining reasons for rejecting the opinion. The 24 ALJ’s dictum there does not bind the Commissioner here. 1 on knowledge of longitudinal record). Even if the ALJ erred in finding Dr. Morgan’s opinion 2 unpersuasive, then, the ALJ’s decision would not be affected, as the ALJ reasonably found Dr. 3 Jenkins-Guarnieri’s opinion to be more persuasive, and largely credited that opinion. For this 4 reason, any error committed with respect to Dr. Morgan’s opinion is harmless, as the Court is
5 “able to conclude from the record that the ALJ would have reached the same result absent the 6 error.” Molina v. Astrue, 674 F.3d 1104, 1115 (9th Cir. 2012). 7 IV. CONCLUSION 8 For the foregoing reasons, the Court hereby AFFIRMS Defendant’s decision denying 9 benefits. 10 Dated this 6th day of June, 2025. 11 A 12 David W. Christel United States Magistrate Judge 13 14 15 16 17 18 19 20 21 22 23 24