1 WO 2 3 4 5 6 IN THE UNITED STATES DISTRICT COURT 7 FOR THE DISTRICT OF ARIZONA
9 Michael B Wallace, No. CV-22-00971-PHX-DWL
10 Plaintiff, ORDER
11 v.
12 Commissioner of Social Security Administration, 13 Defendant. 14 15 Plaintiff Michael B. Wallace (“Plaintiff”) challenges the denial of his application 16 for benefits under the Social Security Act (“the Act”) by the Commissioner of the Social 17 Security Administration (“Commissioner”). The Court has reviewed Plaintiff’s opening 18 brief (Doc. 13), the Commissioner’s answering brief (Doc. 17), and Plaintiff’s reply (Doc. 19 18), as well as the Administrative Record (Doc. 10, “AR”), and now affirms the 20 Administrative Law Judge’s (“ALJ”) decision. 21 I. Procedural History 22 On February 20, 2020, Plaintiff filed an application for disability and disability 23 insurance benefits, eventually alleging a disability onset date of January 1, 2020. (AR at 24 20-21.) The Social Security Administration (“SSA”) denied Plaintiff’s application at the 25 initial and reconsideration levels of administrative review and Plaintiff requested a hearing 26 before an ALJ. (Id. at 20.) On May 10, 2021, following a telephonic hearing, the ALJ 27 issued an unfavorable decision. (Id. at 20-31.) The Appeals Council later denied review. 28 (Id. at 1-7.) 1 II. Sequential Evaluation Process And Judicial Review 2 To determine whether a claimant is disabled for purposes of the Act, the ALJ 3 follows a five-step process. 20 C.F.R. § 416.920(a). The claimant bears the burden of 4 proof at the first four steps, but the burden shifts to the Commissioner at step five. Tackett 5 v. Apfel, 180 F.3d 1094, 1098 (9th Cir. 1999). At the first step, the ALJ determines whether 6 the claimant has engaged in substantial, gainful work activity. 20 C.F.R. 7 § 416.920(a)(4)(i). At step two, the ALJ determines whether the claimant has a “severe” 8 medically determinable physical or mental impairment. Id. § 416.920(a)(4)(ii). At step 9 three, the ALJ considers whether the claimant’s impairment or combination of impairments 10 meets or medically equals an impairment listed in Appendix 1 to Subpart P of 20 C.F.R. 11 Part 404. Id. § 416.920(a)(4)(iii). If so, the claimant is disabled. Id. If not, the ALJ 12 assesses the claimant’s residual functional capacity (“RFC”) and proceeds to step four, 13 where the ALJ determines whether the claimant is still capable of performing past relevant 14 work. Id. § 416.920(a)(4)(iv). If not, the ALJ proceeds to the fifth and final step, where 15 the ALJ determines whether the claimant can perform any other work in the national 16 economy based on the claimant’s RFC, age, education, and work experience. Id. 17 § 416.920(a)(4)(v). If not, the claimant is disabled. Id. 18 An ALJ’s factual findings “shall be conclusive if supported by substantial 19 evidence.” Biestek v. Berryhill, 139 S. Ct. 1148, 1153 (2019) (citations omitted) (internal 20 quotations omitted). The Court may set aside the Commissioner’s disability determination 21 only if it is not supported by substantial evidence or is based on legal error. Orn v. Astrue, 22 495 F.3d 625, 630 (9th Cir. 2007). Substantial evidence is relevant evidence that a 23 reasonable person might accept as adequate to support a conclusion considering the record 24 as a whole. Id. Generally, “[w]here the evidence is susceptible to more than one rational 25 interpretation, one of which supports the ALJ’s decision, the ALJ’s conclusion must be 26 upheld.” Thomas v. Barnhart, 278 F.3d 947, 954 (9th Cir. 2002) (citation omitted). In 27 determining whether to reverse an ALJ’s decision, the district court reviews only those 28 issues raised by the party challenging the decision. Lewis v. Apfel, 236 F.3d 503, 517 n.13 1 (9th Cir. 2001). 2 III. The ALJ’s Decision 3 The ALJ found that Plaintiff had not engaged in substantial, gainful work activity 4 since the amended alleged onset date and that Plaintiff had the following severe 5 impairments: “cervical spine degenerative disc disease with stenosis status post cervical 6 fusion and lumbar degenerative disc disease with stenosis.” (AR at 23.)1 Next, the ALJ 7 concluded that Plaintiff’s impairments did not meet or medically equal a listing. (Id. at 8 24.) Next, the ALJ calculated Plaintiff’s RFC as follows: 9 [T]he claimant has the residual functional capacity to perform a range of light 10 work as defined in 20 CFR 404.1567(b). Specifically, the claimant can lift and carry up to 20 pounds occasionally and 10 pounds frequently; he can 11 stand and/or walk for 6 hours out of an 8-hour workday with normal breaks; 12 he can sit for 6 hours out of an 8-hour workday with normal breaks; he can never climb ladders, ropes, or scaffolds; he can occasionally climb ramps or 13 stairs, stoop, kneel, crouch, or crawl; he can frequently balance; he can 14 occasionally reach overhead bilaterally; he can occasionally operate foot controls bilaterally; he can occasionally be exposed to excessive vibration; 15 he can occasionally be exposed to dangerous, moving machinery and unprotected heights; and he is allowed to stand and stretch one minute every 16 hour when sitting. 17 18 (Id.) 19 As part of this RFC determination, the ALJ evaluated Plaintiff’s symptom 20 testimony, concluding that Plaintiff’s “medically determinable impairments could 21 reasonably be expected to cause the alleged symptoms; however, the claimant’s statements 22 concerning the intensity, persistence and limiting effects of these symptoms are not entirely 23 consistent with the medical evidence and other evidence in the record for the reasons 24 explained in this decision.” (Id. at 25.) The ALJ also evaluated opinion evidence from 25 various medical sources, concluding as follows: (1) Dr. S. Gupta, M.D., state agency 26 medical consultant (most “persuasive”); (2) Dr. M. Keer, D.O., state agency medical 27 1 The ALJ also noted that Plaintiff presented evidence of “gastroesophageal reflux 28 disease, hypertension, and mild bilateral hand arthritis” but found that these impairments were not severe. (Id. at 23.) 1 consultant (most “persuasive”); (3) Dr. Nima Salari, M.D., examining doctor (generally 2 “unpersuasive”); and (4) Daniel J. Schneider, physical therapist (“unpersuasive”). (Id. at 3 27-29.) Additionally, the ALJ considered third-party reports from Plaintiff’s wife and 4 friend but concluded that those reports did “not support the inclusion of greater limitations 5 in the [RFC].” (Id. at 29.) 6 Based on the testimony of a vocational expert (“VE”), the ALJ concluded that 7 Plaintiff was capable of performing his past relevant work as a telephone salesman and 8 sales representative or estimator. (Id. at 30-31.) Thus, the ALJ concluded that Plaintiff 9 was not disabled. (Id. at 31.) 10 IV. Discussion 11 Plaintiff raises three issues on appeal: (1) whether the ALJ erred in analyzing Dr. 12 Salari’s opinions; (2) whether the ALJ improperly discredited Plaintiff’s symptom 13 testimony; and (3) whether the ALJ improperly rejected lay witness testimony. (Doc. 13 14 at 1-2.) As a remedy, Plaintiff seeks a remand for “payment of benefits” or a de novo 15 hearing. (Id. at 2.) 16 A. Dr. Salari 17 1. Standard Of Review 18 In January 2017, the SSA amended the regulations concerning the evaluation of 19 medical opinion evidence. See Revisions to Rules Regarding Evaluation of Medical 20 Evidence, 82 Fed. Reg. 5844 (Jan. 18, 2017). The new regulations apply to applications 21 filed on or after March 27, 2017, and are therefore applicable here. The new regulations 22 provide in relevant part as follows: 23 We will not defer or give any specific evidentiary weight, including 24 controlling weight, to any medical opinion(s) or prior administrative medical finding(s), including those from your medical sources. . . . The most 25 important factors we consider when we evaluate the persuasiveness of 26 medical opinions and prior administrative medical findings are supportability . . . and consistency . . . . 27 28 20 C.F.R. § 416.920c(a). Regarding the “supportability” factor, the new regulations 1 explain that the “more relevant the objective medical evidence and supporting explanations 2 presented by a medical source are to support his or her medical opinion(s), . . . the more 3 persuasive the medical opinions . . . will be.” Id. § 404.1520c(c)(1). Regarding the 4 “consistency” factor, the “more consistent a medical opinion(s) . . . is with the evidence 5 from other medical sources and nonmedical sources in the claim, the more persuasive the 6 medical opinion(s) . . . will be.” Id. § 404.1520c(c)(2).2 7 Recently, the Ninth Circuit confirmed that the “recent changes to the Social Security 8 Administration’s regulations displace our longstanding case law requiring an ALJ to 9 provide ‘specific and legitimate’ reasons for rejecting an examining doctor’s opinion.” 10 Woods v. Kijakazi, 32 F.4th 785, 787 (9th Cir. 2022). Thus, “the former hierarchy of 11 medical opinions—in which we assign presumptive weight based on the extent of the 12 doctor’s relationship with the claimant—no longer applies. Now, an ALJ’s decision, 13 including the decision to discredit any medical opinion, must simply be supported by 14 substantial evidence.” Id. With that said, “[e]ven under the new regulations, an ALJ cannot 15 reject an examining or treating doctor’s opinion as unsupported or inconsistent without 16 providing an explanation supported by substantial evidence. The agency must articulate 17 how persuasive it finds all of the medical opinions from each doctor or other source and 18 explain how it considered the supportability and consistency factors in reaching these 19 findings.” Id. at 792 (cleaned up). Although “an ALJ can still consider the length and 20 purpose of the treatment relationship, the frequency of examinations, the kinds and extent 21 of examinations that the medical source has performed or ordered from specialists, and 22 whether the medical source has examined the claimant or merely reviewed the claimant’s 23 records. . . . [T]he ALJ no longer needs to make specific findings regarding these 24 relationship factors . . . .” Id. (citation omitted). 25 … 26
27 2 Other factors that may be considered by the ALJ in addition to supportability and consistency include the provider’s relationship with the claimant, the length of the 28 treatment relationship, the frequency of examinations, the purpose and extent of the treatment relationship, and the specialization of the provider. Id. § 416.920c(c). 1 2. Dr. Salari’s Opinions 2 Plaintiff’s treating doctor, Dr. Salari, completed a “Residual Functional Capacity 3 Questionnaire—Lumbar Spine” on March 17, 2021. (AR at 524-26.) In that form, Dr. 4 Salari opined that Plaintiff could only work four hours per day, could only work 20 hours 5 per week, and would likely be absent from work more than four days each month. (Id. at 6 525-26.) Dr. Salari also opined that Plaintiff could only sit for one hour at a time; could 7 only sit for four hours in an eight-hour workday; could only stand for 30 minutes at a time; 8 could only stand for two hours in an eight-hour workday; could only walk for 30 minutes 9 at a time; and could only walk for two hours in an eight-hour workday. (Id. at 525.) 10 Additionally, Dr. Salari opined that Plaintiff’s physical restrictions would cause various 11 non-exertional limitations, including “moderately severe” limitations in Plaintiff’s ability 12 to pay attention to and/or concentrate on tasks; to maintain interpersonal relationships with 13 supervisors, co-workers, or the public; to respond to customary work pressures or stress; 14 and to provide consistent work effort. (Id. at 526.) 15 Additionally, Dr. Salari completed four listing questionnaires. First, on March 17, 16 2021, Dr. Salari completed a form entitled “Listing 1.04 Questionnaire.” (Id. at 523.) 17 There, Dr. Salari checked boxes indicating that Plaintiff had two impairments (first, “a 18 disorder of the spine . . . resulting in compromise of a nerve root . . . or the spinal cord”; 19 and second, “nerve root compression characterized by [among other things] motor loss 20 (atrophy with associated muscle weakness or muscle weakness) accompanied by sensory 21 or reflex loss”), confirmed that “I have reviewed the Commissioner’s Listing of 22 Impairments, Section 1.00 through 1.04,” and opined that Listing 1.04 was met or equaled 23 as early as January 2020. (Id.) Second, on March 31, 2021, Dr. Salari completed another 24 version of Listing Questionnaire 1.04. (Id. at 550.) There, Dr. Salari stated that Plaintiff’s 25 functional restrictions were first present on May 1, 2019. (Id. at 550.) Third, on April 21, 26 2021, Dr. Salari completed a form entitled “Listing Questionnaire 1.15.” (Id. at 551-52.) 27 There, Dr. Salari opined that although Plaintiff had “a disorder of the skeletal spine 28 resulting in compromise of a nerve root(s),” that condition did not satisfy all of the 1 necessary requirements under Listing 1.15. (Id.) Fourth, also on April 21, 2021, Dr. Salari 2 completed a form entitled “Listing Questionnaire 1.16.” (Id. at 553-54.) There, Dr. Salari 3 opined that although Plaintiff had “lumbar spinal stenosis resulting in compromise of the 4 cauda equina,” that condition did not satisfy all of the necessary requirements under Listing 5 1.16. (Id.) 6 3. The ALJ’s Evaluation Of Dr. Salari’s Opinions 7 The ALJ deemed Dr. Salari’s opinions “unpersuasive,” albeit with one caveat. (Id. 8 at 28.) The ALJ’s full rationale was as follows: 9 The medical opinions of Dr. Salari are unpersuasive because the assessments 10 are not supported by relevant objective medical evidence, inconsistent with evidence from other medical and nonmedical sources, and contradicted by 11 other factors. In forms dated March 17, 2021, Dr. Salari opined that the 12 claimant met section 1.04A. In another form dated March 17, 2021, Dr. Salari also opined the claimant could only work four hours a day, 20 hours a 13 week including standing and walking a total of two hours each in an eight 14 hour workday. The doctor also determined the claimant would likely be absent from work more than four times a month as a result of his impairments 15 or treatment. In a form dated March 31, 2021, Dr. Salari opined the claimant met listing 1.04A prior to January 1, 2020. 16 17 First, a supportable explanation was not provided because there were insufficient references to medically acceptable objective clinical or 18 diagnostic findings and seem to be based on the claimant’s subjective 19 complaints. Second, a supportable explanation was not provided because the medical source merely checked boxes on a form and the lines on the form 20 allowing for an explanation were inadequately completed. The March 17, 21 2021 form is internally inconsistent indicating the claimant can only work four hours per day, but can sit 4 hours per day, stand 2 hours per day, and 22 walk 2 hours per day. Third, the objective medical evidence, including the claimant’s use of only standard treatment, does not support the extreme 23 assessments. For instance, regarding listing 1.04, there was no consistent 24 evidence of motor loss of atrophy. There was also no need for an assistive device. The undersigned also notes this listing is obsolete and listings 1.15 25 and 1.16 are now applicable. Fourth, evidence from other medical or 26 nonmedical sources are inconsistent with the assessments. Fifth, the medical opinion is inconsistent with the claimant’s admitted activities of daily living, 27 which have already been described above in this decision. Performance of 28 this wide range of ordinary tasks is inconsistent with severe limitations and casts doubts on this opinion. Accordingly, these opinions are unpersuasive. 1 Later, in a form dated April 21, 2021, Dr. Salari indicated that the claimant did not meet listing 1.15 or listing 1.16. The undersigned finds this specific 2 opinion is persuasive based on factors of supportability and consistency. 3 This opinion is consistent with the claimant’s clinical and diagnostic findings as detailed above. Hence, the undersigned find this opinion is persuasive. 4 5 (Id., cleaned up.) 6 4. The Parties’ Arguments 7 Plaintiff argues that the ALJ “improperly rejected critical aspects of Dr. Salari’s 8 opinion in the absence of legally adequate reasons for doing so.” (Doc. 13 at 16.)3 9 According to Plaintiff, “Dr. Salari’s opinions were not inconsistent with the medical 10 treatment notes from other medical evidence he reviewed, including [Plaintiff’s] diagnostic 11 imaging.” (Id. at 11.) More specifically, Plaintiff argues that (1) although the ALJ viewed 12 Dr. Salari’s opinion that Plaintiff had “‘decreased sensation’ in upper extremity” as 13 inconsistent with Dr. McCunniff’s treatment notes indicating “that [Plaintiff] had ‘normal 14 sensation in the upper extremity,’” this finding of inconsistency was based on a 15 mischaracterization of Dr. McCunniff’s notes; (2) Dr. Salari’s opined limitations are 16 consistent with the evidence in the record concerning Plaintiff’s daily activities, which 17 demonstrates that Plaintiff cannot play guitar, sit comfortably on a three-hour flight, or 18 drive; and (3) Dr. Salari’s opinions are consistent with Plaintiff’s conservative course of 19 treatment because Dr. Salari later recommended surgery. (Id. at 12-15, cleaned up.) 20 Regarding supportability, Plaintiff argues that “contrary to the ALJ’s assertion, Dr. Salari 21 did support his conclusions with a full examination of [Plaintiff], including objective 22 findings, and did not base his conclusions solely on [Plaintiff’s] subjective complaints.” 23 (Id. at 12.) Plaintiff argues that “Dr. Salari offered a detailed explanation as to how 24 [Plaintiff’s] imaging results corresponded to his symptoms and [Plaintiff’s] functional 25
26 3 One of Plaintiff’s specific arguments is that the ALJ improperly accused Dr. Salari of being biased by stating that “Wallace was evaluated by Dr. Salari ‘at request of 27 attorney.’” (Id. at 10.) In response, the Commissioner contends that the ALJ “made no findings that the opinion was therefore ‘biased’” and that Plaintiff’s argument is “wholly 28 speculative.” (Doc. 17 at 14.) The Court agrees with the Commissioner that the ALJ did not cite bias as a reason to discredit Dr. Salari’s opinions. 1 limitations. Dr. Salari did not simply ‘check boxes on a form’ as the ALJ asserts.” (Id.) 2 The Commissioner disagrees and defends the sufficiency of the ALJ’s rationale. 3 (Doc. 17 at 10-14.) The Commissioner contends there is substantial evidence to support 4 the ALJ’s evaluation of supportability because “[Dr. Salari’s] opinions lacked references 5 to objective medical evidence and instead appeared significantly based on Plaintiff’s 6 subjective symptom complaints, which the ALJ discounted for good reasons.” (Id. at 11, 7 citations omitted.) The Commissioner also argues that it was permissible for the ALJ to 8 discount Dr. Salari’s opinions because Dr. Salari “‘merely checked boxes on a form’ and 9 ‘inadequately completed’ the lines on the form that allowed for more explanation.” (Id., 10 citation omitted) As for the consistency factor, the Commissioner contends that substantial 11 evidence supports the ALJ’s findings that (1) “Dr. Salari made unsupported ‘extreme 12 assessments’ that were inconsistent with the record as a whole”; (2) “Dr. Salari’s form 13 opinion was ‘internally inconsistent’”; (3) Dr. Salari’s “opinion was inconsistent with other 14 medical source opinion evidence, including the prior administrative findings of Drs. Gupta 15 and Keer”; and (4) “Dr. Salari’s opinion was inconsistent with Plaintiff’s daily activities.” 16 (Id. at 12-14, citations omitted.) In response to Plaintiff’s contention that the ALJ 17 mischaracterized Dr. McCunniff’s treatment notes, the Commissioner argues that Dr. 18 McCunniff made a typographical error by referring to the lower extremity rather than the 19 upper extremity because other treatment notes from Dr. McCunniff’s clinic cite normal 20 sensation in Plaintiff’s upper extremities. (Id. at 13, citations omitted.) 21 In reply, Plaintiff essentially restates the arguments that appear in his opening brief. 22 (Doc. 18 at 2-4.) 23 5. Analysis 24 The ALJ’s evaluation of Dr. Salari’s opinions was free of harmful error. As noted, 25 “[t]he agency must articulate how persuasive it finds all of the medical opinions from each 26 doctor or other source and explain how it considered the supportability and consistency 27 factors in reaching these findings.” Woods, 32 F.4th at 792 (cleaned up). Here, the ALJ 28 expressly considered both of the required factors. (AR at 28 [concluding, inter alia, that 1 “[t]he medical opinions of Dr. Salari are unpersuasive because the assessments are not 2 supported by relevant objective medical evidence [and] inconsistent with evidence from 3 other medical and nonmedical sources,” because “a supportable explanation was not 4 provided,” and because “evidence from other medical or nonmedical sources [is] 5 inconsistent with the assessments”].) 6 Additionally, the ALJ’s conclusions as to each factor were supported by substantial 7 evidence. Beginning with the consistency factor, one of the ALJ’s proffered reasons for 8 discounting Dr. Salari’s opinions was that “the objective medical evidence . . . does not 9 support the extreme assessments. For instance, regarding listing 1.04, there was no 10 consistent evidence of motor loss o[r] atrophy.” (AR at 28.) Substantial evidence supports 11 this conclusion. As noted, in the Listing 1.04 Questionnaire, Dr. Salari indicated that 12 Plaintiff had “nerve root compression characterized by [among other things] motor loss 13 (atrophy with associated muscle weakness or muscle weakness) accompanied by sensory 14 or reflex loss.” (AR at 523.) However, multiple other providers indicated in treatment 15 records that Plaintiff did not have motor loss/atrophy accompanied by sensory or reflex 16 loss. (See, e.g., id. at 336-37 [March 4, 2020 note from PT Jagodzinski, indicating normal 17 gait]; id. at 344 [January 13, 2020 note from NP Rach, indicating that Plaintiff “denies leg 18 weakness, numbness or tingling” and that Plaintiff had “normal gait and station]; id. at 353 19 [March 5, 2020 note from NP Rach, again indicating “Normal gait”]; id. at 403 [February 20 26, 2020 note from FNP-C Oarde: “NO obvious wasting atrophy of the limbs, 21 STRENGTH: 5/5 . . . , SENSATION: intact throughout”]; id. at 410 [March 5, 2020 22 note from FNP-C Mello, indicating “Normal gait,” 4/5 strength, and intact sensation]; id. 23 at 483 [November 23, 2020 note from Dr. Baker: “neuro strength 4/5, gait stable”]; id. at 24 505 [March 9, 2021 note from Dr. McCunniff: “There is 5/5 motor strength in all muscle 25 groups of the lower extremities”]; id. at 508-09 [February 23, 2021 “Nerve Conduction & 26 Electromyographic Report,” concluding that “[t]he motor conduction test was normal in 27 all 4 of the tested nerves”].) It was rational for the ALJ to conclude that these objective 28 medical records were inconsistent with Dr. Salari’s opinions. Thomas, 278 F.3d at 954 1 (“Where the evidence is susceptible to more than one rational interpretation, one of which 2 supports the ALJ’s decision, the ALJ’s conclusion must be upheld.”) (citation omitted). 3 Cf. Rolus v. Colvin, 2016 WL 5316821, *3 (W.D. Okla. 2016) (noting that “absent evidence 4 of muscle atrophy/sensory loss, [a claimant] cannot meet Listing 1.04(A)” and affirming 5 the ALJ’s determination that Listing 1.04(A) was not satisfied because the ALJ cited 6 examination records in which providers indicated that the claimant had “no evidence of 7 muscular atrophy” and “no sensory loss in [his] lumbosacral spine”). 8 Another of the ALJ’s proffered reasons for discounting Dr. Salari’s opinions 9 pursuant to the consistency factor was that they conflicted with the less-restrictive opinions 10 of the other medical sources whom the ALJ deemed persuasive. (AR at 28 [“Fourth, 11 evidence from other medical or nonmedical sources are inconsistent with the 12 assessments.”].) This, too, is a permissible basis for discounting a medical source’s 13 opinions. See generally 20 C.F.R. § 404.1520c(c)(2) (“The more consistent a medical 14 opinion(s) . . . is with the evidence from other medical sources and nonmedical sources in 15 the claim, the more persuasive the medical opinion(s) . . . will be.”). Cf. Michele I. v. 16 Comm’r, Soc. Sec. Admin., 2022 WL 4533962, *5-6 (D. Or. 2022) (“The ALJ did not err 17 in his consideration of PA Laughlin-Hall’s opinion. The ALJ considered the two most 18 important factors in evaluating PA Laughlin-Hall’s medical opinion—supportability and 19 consistency—and the record supports the ALJ’s conclusions. The ALJ . . . not[ed] PA 20 Laughlin-Hall’s opinion ‘markedly conflict[s] with opinions of the reviewing physicians 21 for the State agency who examined the claimant’s medical records’ . . . . The ALJ’s 22 consideration of PA Laughlin-Hall’s medical opinion is supported by substantial 23 evidence.”); Rafael G. v. Kijakazi, 2022 WL 3019935, *6 (S.D. Cal. 2022) 24 (“[I]inconsistency with two similar agency consultant opinions further supports the ALJ’s 25 inconsistency finding.”). The ALJ’s finding of inconsistency was also supported by 26 substantial evidence—for example, Dr. Salari’s opinion that Plaintiff could only stand and 27 walk for two hours in an eight-hour workday (AR at 525) conflicted with the “more 28 persuasive” opinions of the state agency consultants, who opined that Plaintiff could stand 1 and walk for six hours in an eight-hour workday (id. at 27, citing id. at 89, 104). 2 Given these conclusions, it is unnecessary to resolve Plaintiff’s challenges to the 3 ALJ’s other reasons for discounting Dr. Salari’s opinions pursuant to the consistency 4 factor. Any error (including any error regarding the ALJ’s summary of Dr. McCunniff’s 5 notes) was harmless in light of the sufficiency of the ALJ’s other reasons. See, e.g., Reed 6 v. Saul, 834 F. App’x 326, 329 (9th Cir. 2020) (“To the extent the ALJ erred in discounting 7 the opinions of Dr. Cochran because her opinions were based in part on Reed’s self-reports 8 of his symptoms, that error is harmless because the ALJ offered multiple other specific and 9 legitimate reasons for discounting Dr. Cochran’s opinions.”); Baker v. Berryhill, 720 F. 10 App’x 352, 355 (9th Cir. 2017) (“Two of the reasons the ALJ provided for discounting 11 examining psychologist Dr. Wheeler’s opinion were not legally valid . . . [but] the ALJ 12 provided other specific and legitimate reasons for discounting Dr. Wheeler’s opinion. . . . 13 As a result, any error was harmless.”); Presley-Carrillo v. Berryhill, 692 F. App’x 941, 14 944-45 (9th Cir. 2017) (“The ALJ also criticized Dr. Van Eerd’s opinion in part because 15 Dr. Van Eerd did not define the terms ‘mild,’ ‘moderate,’ or ‘severe’ in his assessment. 16 This criticism was improper . . . [but] this error was harmless because the ALJ gave a reason 17 supported by the record for not giving much weight to Dr. Van Eerd’s opinion— 18 specifically, that it conflicted with more recent treatment notes from Dr. Mateus.”). 19 Turning to the supportability factor, one of the ALJ’s proffered reasons for 20 discounting Dr. Salari’s opinions was that “a supportable explanation was not provided 21 because there were insufficient references to medically acceptable objective clinical or 22 diagnostic findings and seem to be based on the claimant’s subjective complaints.” (AR 23 at 28.) This conclusion, albeit expressed with less than ideal clarity, was supported by 24 substantial evidence. As discussed above, one of Dr. Salari’s opinions was that Plaintiff 25 had motor loss/atrophy accompanied by sensory or reflex loss. In addition to being 26 inconsistent with the objective treatment records from other medical providers (and thus 27 discountable pursuant to the consistency factor), this opinion was also inconsistent with 28 Dr. Salari’s own records—in the RFC questionnaire, Dr. Salari did not indicate that 1 Plaintiff had an abnormal gait. (Id. at 524.) Similarly, Dr. Salari’s notes from a motor 2 examination of Plaintiff indicate that Plaintiff had 5/5 strength in all lower extremities, 3 with the caveat that “[p]atient subjectively complained of increased pain throughout the 4 motor exam.” (Id. at 519, emphasis added.) It was rational under these circumstances for 5 the ALJ to conclude that Dr. Salari’s opinions could be discounted pursuant to the 6 supportability factor. 7 Another of the ALJ’s proffered reasons for discounting Dr. Salari’s opinions was 8 that they were internally inconsistent. (Id. at 28 [concluding that “a supportable 9 explanation was not provided because,” inter alia, “[t]he March 17, 2021 form is internally 10 inconsistent” and Dr. Salari offered conflicting opinions in the “form[s] dated April 21, 11 2021 [which] indicated that the claimant did not meet listing 1.15 or listing 1.16”].) This 12 is another permissible basis for discounting a medical source’s opinions pursuant to the 13 supportability factor. See, e.g., Katherine M. v. Comm’r of Soc. Sec., 2022 WL 36891, *4 14 (W.D. Wash. 2022) (“Plaintiff has not shown that the ALJ erred by finding Dr. Sciarrone’s 15 opinion unpersuasive by considering the internal inconsistencies in the doctor’s opinion.”). 16 See generally Morgan v. Comm’r of Soc. Sec. Admin., 169 F.3d 595, 603 (9th Cir. 1999) 17 (“Internal inconsistencies within Dr. Reaves’s and Dr. Grosscup’s reports . . . also 18 constitute relevant evidence . . . [from which the ALJ could] discount the opinions of Dr. 19 Reaves and Dr. Grosscup . . . .”). The ALJ’s finding of internal inconsistency was 20 supported by substantial evidence. Although Dr. Salari opined in the Listing 1.04 21 Questionnaire that Plaintiff had motor loss/atrophy accompanied by sensory or reflex loss 22 (AR at 523), Dr. Salari opined in Listing Questionnaire 1.15 that Plaintiff did not have any 23 “[m]uscle weakness” or “[s]ign(s) of nerve root irritation, tension, or compression, 24 consistent with compromise of the affected nerve root” (id. at 551) and opined in Listing 25 Questionnaire 1.16 that Plaintiff did not have any “[m]uscle weakness” or “[s]ensory nerve 26 deficit . . . on electrodiagnostic testing” (id. at 553). It was rational for the ALJ to conclude 27 that these opinions were inconsistent. Separately, although Dr. Salari opined in the RFC 28 questionnaire that Plaintiff could only work four hours a day, Dr. Solari also concluded a 1 few lines later that during an eight-hour day, Plaintiff could sit for four hours, stand for two 2 hours, and walk for two hours. (Id. at 525.) It was also rational for the ALJ to conclude 3 that these findings were internally inconsistent. 4 Given these conclusions, it is unnecessary to resolve Plaintiff’s challenges to the 5 ALJ’s other reasons for discounting Dr. Salari’s opinions pursuant to the supportabilty 6 factor. Reed, 834 F. App’x at 329; Baker, 720 F. App’x at 355; Presley-Carrillo, 692 F. 7 App’x at 944-45. 8 B. Symptom Testimony 9 1. Standard Of Review 10 An ALJ must evaluate whether the claimant has presented objective medical 11 evidence of an impairment that “could reasonably be expected to produce the pain or other 12 symptoms alleged.” Lingenfelter v. Astrue, 504 F.3d 1028, 1036 (9th Cir. 2007) (citation 13 omitted). If so, “an ALJ may not reject a claimant’s subjective complaints based solely on 14 a lack of medical evidence to fully corroborate the alleged severity of pain.” Burch v. 15 Barnhart, 400 F.3d 676, 680 (9th Cir. 2005) (citation omitted). Instead, the ALJ may 16 “reject the claimant’s testimony about the severity of [the] symptoms” only by “offering 17 specific, clear and convincing reasons for doing so.” Brown-Hunter v. Colvin, 806 F.3d 18 487, 488-89 (9th Cir. 2015) (citation omitted). 19 2. The ALJ’s Evaluation Of Plaintiff’s Symptom Testimony 20 The ALJ held that Plaintiff’s “medically determinable impairments could 21 reasonably be expected to cause the alleged symptoms; however, the claimant’s statements 22 concerning the intensity, persistence and limiting effects of these symptoms are not entirely 23 consistent with the medical evidence and other evidence in the record for the reasons 24 explained in this decision.” (AR at 25.) The ALJ then identified what the Court perceives 25 to be three reasons for discounting Plaintiff’s symptom testimony. (Id. at 25-27.) 26 The first reason was inconsistency with the objective medical evidence. After 27 noting that “musculoskeletal examinations . . . generally showed normal, full strength of 28 the bilateral upper extremities and bilateral lower extremities and no distress despite 1 complaints,” noting that Plaintiff’s “straight-leg-raising-test was negative on March 5, 2 2020,” and discussing various pieces of “diagnostic evidence,” the ALJ concluded that 3 those records were inconsistent with Plaintiff’s claimed “inability to work due to chronic 4 pain, numbness and tingling in bilateral lower extremities and inability to engage in 5 prolonged sitting and/or standing status post several motor vehicle accidents.” (Id. at 25- 6 27.) 7 The second reason was Plaintiff’s pursuit of “only conservative and/or standard 8 treatment,” which the ALJ deemed “not comparable to” the “degree of the claimant’s 9 subjective complaints.” (Id. at 26-27.) In support, the ALJ cited treatment notes stating 10 that Plaintiff pursued “treatment with a pain management specialist, physical therapy, and 11 injections” and reported symptom relief of up to 80% after such treatments. (Id. at 26.) 12 The third reason was inconsistency with Plaintiff’s activities of daily living 13 (“ADLs”). The ALJ found that Plaintiff “described daily activities that are not limited to 14 the extent one would expect, given the complaints of disabling symptoms and limitations.” 15 (Id. at 27.) For example, the ALJ noted that Plaintiff “uses a salt-water pool and kicks with 16 his legs to relieve pain” and “tries to go every day, five to six days a week and is in there 17 an hour and a half and then is in sauna [for a] half hour.” (Id., citation omitted.) The ALJ 18 also noted that Plaintiff drives, “has to stretch two hours before he gets up,” “‘frequently 19 practices’ playing guitar,” and “just flew to Seattle and sat on [an] airplane for three hours” 20 after walking to the gate without a wheelchair. (Id., citations omitted.) 21 3. The Parties’ Arguments 22 Plaintiff argues that the ALJ failed to provide “specific, clear, and convincing 23 findings” to discredit his symptom testimony. (Doc. 13 at 16-19.) Plaintiff argues that the 24 ALJ’s reasoning is flawed because (1) “[i]t was improper for the ALJ to single out ‘a few 25 periods of temporary well-being from a sustained period of impairment’” when the record 26 supports that he cannot “sustain activity for a full work day and work week”; (2) “Dr. 27 Salari[] opined that [Plaintiff’s] reports of symptoms were entirely consistent with the 28 physical examination results and with the results Dr. Salari reviewed from the [X]-Rays 1 and MRIs of [Plaintiff’s] lumbar and cervical spine” and, in contrast, “[t]he ALJ has not 2 identified any specific aspect of the medical evidence which is actually inconsistent with 3 any specific aspect of [Plaintiff’s] testimony”; and (3) his pursuit of conservative treatment 4 methods should not be viewed as discrediting because “Dr. Salari opined that [he] had 5 exhausted his conservative options for treatment and that surgery was the likely next step.” 6 (Id. at 17-19, cleaned up.) 7 In response, the Commissioner contends that “the ALJ [properly] discounted 8 Plaintiff’s subjective symptom complaints because of inconsistencies with (1) objective 9 medical and other evidence, (2) improvements through conservative treatment, and (3) 10 activities of daily living.” (Doc. 17 at 6.) More specifically, the Commissioner first argues 11 that Plaintiff’s testimony was inconsistent with the objective medical evidence because 12 although Plaintiff testified that he could not “engage in prolonged sitting and/or standing,” 13 medical evidence demonstrated that (1) “Plaintiff could sit, stand, walk, and balance 14 frequently; he could also reach, stoop, and crouch occasionally”; (2) despite one recent 15 positive straight leg raising (“SLR”) test in 2021, Plaintiff had a negative balance test, 16 several negative SLRs in 2020, “normal gait,” and “demonstrated ‘5/5 motor strength in 17 all muscle groups of the lower extremities’ and intact sensation”; and (3) Plaintiff did not 18 have “muscle wasting or atrophy.” (Id. at 6-7, cleaned up.) Regarding treatment, the 19 Commissioner argues that the ALJ’s analysis did not “single[] out periods of temporary 20 well-being from a sustained period of impairment,” but rather considered Plaintiff’s 21 limitations and improvements over time and concluded that Plaintiff’s improvements over 22 time with “conservative and/or standard treatment” demonstrated “that the degree of the 23 claimant’s subjective complaints is not comparable to the extent of treatment sought by the 24 claimant.” (Id. at 7-9, citations omitted.) Regarding ADLs, the Commissioner argues that 25 “[t]he ALJ found that Plaintiff’s reported activities were inconsistent with the severity of 26 his subjective symptom complaints.” (Id. at 9-10, citation omitted.) 27 In reply, Plaintiff essentially reiterates the arguments from the opening brief, 28 specifically that (1) “[Plaintiff’s] testimony is consistent with the opinion and objective 1 evidence included in the report from his examining doctor, Dr. Salari”; (2) Plaintiff’s 2 conservative treatments “have not provided significant, ongoing relief of his pain, and 3 [Plaintiff’s] doctors have noted that surgery is likely next”; and (3) Plaintiff’s testimony is 4 consistent with Plaintiff’s ADLs. (Doc. 18 at 4-6.) 5 4. Analysis 6 The Court finds no harmful error in the ALJ’s evaluation of Plaintiff’s symptom 7 testimony. 8 First, it was permissible for the ALJ to discount Plaintiff’s symptom testimony on 9 the ground that it was inconsistent with the objective medical evidence in the record. 10 Carmickle v. Comm’r, Soc. Sec. Admin., 533 F.3d 1155, 1161 (9th Cir. 2008) 11 (“Contradiction with the medical record is a sufficient basis for rejecting the claimant’s 12 subjective testimony.”) (citation omitted). Although this may not serve as an ALJ’s sole 13 reason for discounting a claimant’s symptom testimony, it is a permissible consideration 14 when (as here) it is coupled with other grounds for an adverse credibility finding. Smartt 15 v. Kijakazi, 53 F.4th 489, 498 (9th Cir. 2022) (“Claimants like Smartt sometimes 16 mischaracterize [Ninth Circuit law] as completely forbidding an ALJ from using 17 inconsistent objective medical evidence in the record to discount subjective symptom 18 testimony. That is a misreading of [Ninth Circuit law]. When objective medical evidence 19 in the record is inconsistent with the claimant’s subjective testimony, the ALJ may indeed 20 weigh it as undercutting such testimony. We have upheld ALJ decisions that do just that 21 in many cases.”) (citations omitted); Rollins v. Massanari, 261 F.3d 853, 857 (9th Cir. 22 2001) (“While subjective pain testimony cannot be rejected on the sole ground that it is not 23 fully corroborated by objective medical evidence, the medical evidence is still a relevant 24 factor in determining the severity of the claimant’s pain and its disabling effects.”). 25 The ALJ’s finding of inconsistency with the objective medical evidence is supported 26 by substantial evidence. As the Commissioner notes, the ALJ specifically identified 27 medical examinations that “generally showed normal, full strength of the bilateral upper 28 extremities and bilateral lower extremities and no distress despite complaints.” (AR at 25, 1 citing 344-45, 350, 385, 475-98, 500.) It was rational for the ALJ to conclude that such 2 examination results were inconsistent with Plaintiff’s hearing testimony that he “can hardly 3 do anything,” experiences extreme pain from squatting (“probably the most painful thing 4 to do is squat down to the floor”), and cannot even pour a glass of wine without his hands 5 shaking. (Id. at 50, 63.) Although Plaintiff attempts to explain how the cited records could 6 be construed as consistent with his symptom testimony, it was rational for the ALJ to 7 conclude otherwise. Ghanim v. Colvin, 763 F.3d 1154, 1163 (9th Cir. 2014) (“When 8 evidence reasonably supports either confirming or reversing the ALJ’s decision, we may 9 not substitute our judgment for that of the ALJ.”) (citation omitted). 10 Another of the ALJ’s proffered reasons for the adverse credibility finding was 11 inconsistency between Plaintiff’s symptom testimony and Plaintiff’s ADLs. This, too, is 12 a permissible basis for an adverse credibility finding under Ninth Circuit law. Molina v. 13 Astrue, 674 F.3d 1104, 1112-13 (9th Cir. 2012) (“[T]he ALJ may consider inconsistencies 14 . . . between the testimony and the claimant’s conduct . . . and whether the claimant engages 15 in daily activities inconsistent with the alleged symptoms. . . . Even where those activities 16 suggest some difficulty functioning, they may be grounds for discrediting the claimant’s 17 testimony to the extent that they contradict claims of a totally debilitating impairment.”) 18 (cleaned up); Fry v. Berryhill, 749 F. App’x 659, 660 (9th Cir. 2019) (“The ALJ proffered 19 specific, clear, and convincing reasons for discounting Fry’s testimony concerning the 20 severity of her symptoms, including inconsistencies between her daily activities and 21 alleged limitations . . . .”). 22 The ALJ’s finding of inconsistency between Plaintiff’s testimony and ADLs was 23 supported by substantial evidence. Plaintiff asserted in his function reports that his “range 24 of motion is very limited [and] causes pain when moving [his] neck” and that he “cannot 25 sit for long periods or stand for long periods.” (AR at 233-34.) However, Plaintiff 26 elsewhere acknowledged that he can drive for between 30 minutes to “[an hour] or so,” 27 stretches daily for two hours, helps with household chores, swims for physical therapy five- 28 to-six days a week, and plays guitar. (Id. at 50 [stretches]; id. at 52 [household activities]; 1 id. at 53 [guitar]; id. at 57-58 [swimming]; id. at 235 [driving]; id. at 470 [guitar].) 2 Although Plaintiff emphasizes, when describing these activities, that his ability to perform 3 them is limited—he only played three songs on the guitar three months ago and while 4 swimming, he uses a pool noodle (id. at 53, 58)—it was still rational for the ALJ to 5 conclude that Plaintiff’s ability to perform those activities in even a limited fashion was 6 inconsistent with Plaintiff’s more extreme description of his limitations. The Ninth Circuit 7 has recognized that “[i]nconsistencies between a claimant’s testimony and the claimant’s 8 reported activities provide a valid reason for an adverse credibility determination.” Burrell 9 v. Colvin, 775 F.3d 1133, 1137-38 (9th Cir. 2014). This makes sense—a factfinder is 10 entitled to discount the credibility of a witness who has been shown to have testified in a 11 false or exaggerated manner even if the impeaching material does not, on its own, foreclose 12 the claim for relief. See also Tonapetyan v. Halter, 242 F.3d 1144, 1148 (9th Cir. 2001) 13 (recognizing that a “tendency to exaggerate” is a “specific and convincing reason[]” for 14 discrediting a claimant’s testimony); Smolen v. Chater, 80 F.3d 1273, 1284 (9th Cir. 1996) 15 (“To determine whether the claimant’s testimony regarding the severity of her symptoms 16 is credible, the ALJ may consider . . . ordinary techniques of credibility evaluation, such 17 as . . . prior inconsistent statements concerning the symptoms, and other testimony by the 18 claimant that appears less than candid . . . .”). See generally 9th Cir. Model Jury Ins. 1.14 19 (“[I]f you decide that a witness has deliberately testified untruthfully about something 20 important, you may choose not to believe anything that witness said.”). Perhaps a different 21 factfinder might have declined to find inconsistency under these circumstances, but 22 “[w]here the evidence is susceptible to more than one rational interpretation, one of which 23 supports the ALJ’s decision, the ALJ’s conclusion must be upheld.” Thomas, 278 F.3d at 24 954 (citation omitted). 25 Given these conclusions, it is unnecessary to decide whether the ALJ’s third 26 proffered reason for discounting Plaintiff’s symptom testimony—inconsistency with 27 Plaintiff’s conservative course of treatment—was also supported by substantial evidence. 28 Any error as to that issue was harmless because the ALJ identified multiple other clear and 1 convincing reasons, supported by substantial evidence, for discrediting Plaintiff’s 2 testimony. Molina, 674 F.3d at 1115 (“[S]everal of our cases have held that an ALJ’s error 3 was harmless where the ALJ provided one or more invalid reasons for disbelieving a 4 claimant’s testimony, but also provided valid reasons that were supported by the record.”) 5 (citations omitted); Carmickle, 533 F.3d at 1162-63 (“Because we conclude that two of the 6 ALJ’s reasons supporting his adverse credibility finding are invalid, we must determine 7 whether the ALJ’s reliance on such reasons was harmless error. . . . [T]he relevant inquiry 8 in this context is not whether the ALJ would have made a different decision absent any 9 error, it is whether the ALJ’s decision remains legally valid, despite such error. . . . Here, 10 the ALJ’s decision finding Carmickle less than fully credible is valid, despite the errors 11 identified above.”) (citation omitted). 12 C. Lay Witness Testimony 13 1. The Parties’ Arguments 14 Plaintiff notes that his wife, Shari Short, and his friend, Richard Smokovich, each 15 completed “questionnaire[s] describing [his] limitations.” (Doc. 13 at 19-20.) Plaintiff 16 further notes that the ALJ seemed to cross-reference the ALJ’s rationale for discrediting 17 Plaintiff’s symptom testimony when explaining why the ALJ was not fully crediting those 18 third-party statements. (Id.) Plaintiff argues that because “the ALJ’s rationale for 19 discrediting [Plaintiff’s] own testimony was legally inadequate,” that rationale was 20 “equally inadequate as applied to the statements of these witnesses.” (Id. at 20-21.) 21 According to Plaintiff, the ALJ failed “to base the rejection of the lay witness statements 22 on the record and to give specific and legitimate reasons germane to each witness,” 23 meaning “[t]here is no reliable evidence to support the ALJ’s contrary conclusion” that the 24 lay witnesses’ statements are inconsistent with the record. (Id. at 21.) 25 In response, the Commissioner argues that “ALJs are not required to articulate how 26 they consider evidence from non-medical sources” under the new regulations. (Doc. 17 at 27 14.) Alternatively, the Commissioner argues that affirmance is required because “[e]ven 28 if the ALJ had not provided any discussion of the nonmedical source statements, the alleged 1 error would have been harmless because the nonmedical source statements are substantially 2 the same as Plaintiff’s subjective symptom complaints, which the ALJ provided good 3 reasons for discounting.” (Id. at 15, cleaned up.) 4 In reply, Plaintiff essentially reiterates the arguments from his opening brief. (Doc. 5 18 at 6-7.) 6 2. Analysis 7 Plaintiff is not entitled to reversal based on his arguments regarding the lay witness 8 statements. As an initial matter, the Court notes that the Ninth Circuit has not definitively 9 resolved whether ALJs must continue, following the issuance of the new SSA regulations 10 in 2017, to provide reasons for rejecting lay-witness statements. Lower courts have 11 reached conflicting decisions on that issue. Compare Stricker v. Acting Comm’r of Soc. 12 Sec. Admin., 2022 WL 3588215, *6 (D. Ariz. 2022) (“Pursuant to Ninth Circuit caselaw 13 from 1993, ‘[i]f the ALJ wishes to discount the testimony of the lay witnesses, he must 14 give reasons that are germane to each witness’. . . . Defendant argues that caselaw no 15 longer applies because the regulations have changed . . . [but] [t]his regulatory change does 16 not provide that an ALJ need not articulate any reason for discounting evidence from lay 17 witnesses, it only states that the ALJ’s consideration need not follow the requirements for 18 evaluating medical opinions. This regulatory change is not inconsistent with the Ninth 19 Circuit’s germane-reasons standard.”) (citations omitted) with Wendy J. C. v. Saul, 2020 20 WL 6161402, *12 n.9 (D. Or. 2020) (“The new regulations provide the ALJ is ‘not required 21 to articulate how [they] considered evidence from nonmedical sources . . . .’ As such, the 22 ALJ is no longer required to provide reasons germane to lay witnesses to reject their 23 testimony.”) (citations omitted). 24 Nevertheless, even assuming the reasoning requirement remains intact, the Ninth 25 Circuit has recognized that the failure to provide such reasoning is harmless where (1) the 26 ALJ provided legally sufficient reasons for rejecting the claimant’s symptom testimony 27 and (2) the lay witness did not describe any limitations beyond those identified by the 28 claimant. Molina, 674 F.3d at 1122 (“Here, the ALJ failed to explain her reasons for || rejecting the lay witnesses’ testimony. That testimony, however, did not describe any || limitations beyond those Molina herself described, which the ALJ discussed at length and 3 || rejected based on well-supported, clear and convincing reasons. ... Because the ALJ had 4|| validly rejected all the limitations described by the lay witnesses in discussing Molina’s 5 || testimony, we are confident that the ALJ’s failure to give specific witness-by-witness 6|| reasons for rejecting the lay testimony did not alter the ultimate nondisability || determination. Accordingly, the ALJ’s error was harmless.”’). 8 Here, the ALJ satisfied both conditions required for discrediting lay witnesses—the ALJ’s rationale for discrediting Plaintiff’s symptom testimony was legally valid, for the || reasons stated in Part IV.B above, and the third-party statements did not identify any limitations beyond those Plaintiff identified via his own testimony. (AR at 50-70 [Plaintiff’s testimony]; id. at 283-89 [wife’s report]; id. at 290-96 [friend’s report].) 13 || Indeed, Plaintiff does not suggest that his wife’s and friend’s statements described any limitations beyond those he identified—his argument is that because the ALJ’s rationale 15 || for discrediting him was legally insufficient, that rationale was also legally insufficient as 16 || applied to the lay witnesses. For the reasons stated above, that argument is unavailing. 17 Accordingly, 18 IT IS ORDERED that the decision of the ALJ is affirmed. The Clerk shall enter 19 || judgment accordingly and terminate this action. 20 Dated this 30th day of September, 2023. 21 22 Lm 23 i CC —— Dominic W. Lanza IA United States District Judge 25 26 27 28
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