The opinion
IN THE UNITED STATES DISTRICT COURT
FOR THE DISTRICT OF OREGON
HEATH J. 1
Plaintiff, Civ. No. 6:22-cv-00577-AN
v. OPINION AND ORDER
COMMISSIONER OF SOCIAL SECURITY
ADMINISTRATION,
Defendant.
_______________________________________
Plaintiff Heath J. ("Plaintiff") seeks judicial review of the final decision of the
Commissioner of the Social Security Administration denying his claim for supplemental security
income benefits. For the reasons provided below, the Commissioner’s decision is AFFIRMED.
BACKGROUND
Plaintiff is a 55-year-old man who alleges he is unable to work due to mental and
physical impairments. Plaintiff filed an application for Supplemental Security Income benefits
with a protective filing date of April 16, 2018. Tr. 330; see Tr. 14. In his application, Plaintiff
claimed disability with an alleged onset date of September 10, 2017. Id. Plaintiff then amended
the date he claims he became disabled to April 16, 2018. Tr. 362; see Tr. 14. The claim was
denied initially on April 23, 2019 and upon reconsideration on October 22, 2019. Tr. 159, 167.
A telephonic hearing was held on February 10, 2021, before Administrative Law Judge Mark
Triplett due to the Coronavirus Pandemic. Tr. 53-92. On April 1, 2021, the ALJ issued an
1In the interest of privacy, this Opinion and Order uses only the first name and the initial of the last name
of the non-governmental party or parties in this case.
unfavorable decision, finding Plaintiff was not disabled from the alleged onset date, as amended,
through the date of decision. Tr. 14-33. On February 18, 2022, the Appeals Council denied
review, making the ALJ's decision the final agency decision. Tr. 1. This action followed.
DISABILITY ANALYSIS
A claimant is disabled if he or she is unable to "engage in any substantial gainful
activity by reason of any medically determinable physical or mental impairment which . . . has
lasted or can be expected to last for a continuous period of not less than 12 months[.]" 42 U.S.C.
§ 423(d)(1)(A). "Social Security Regulations set out a five-step sequential process for
determining whether an applicant is disabled within the meaning of the Social Security Act."
Keyser v. Comm’r. Soc. Sec. Admin., 648 F.3d 721, 724 (9th Cir. 2011). Each step is potentially
dispositive. 20 C.F.R. §§ 404.1520(a)(4), 416.920(a)(4). The five-step sequential process asks
the following series of questions:
1. Is the claimant performing "substantial gainful activity"? 20 C.F.R.
§§ 404.1520(a)(4)(i); 416.920(a)(4)(i). This activity is work involving
significant mental or physical duties done or intended to be done for pay or
profit. 20 C.F.R. §§ 404.1510; 416.910. If the claimant is performing such
work, she is not disabled within the meaning of the Act. 20 C.F.R.
§§ 404.1520(a)(4)(i); 416.920(a)(4)(i). If the claimant is not performing
substantial gainful activity, the analysis proceeds to step two.
2. Is the claimant's impairment "severe" under the Commissioner’s
regulations? 20 C.F.R. §§ 404.1520(a)(4)(ii); 416.920(a)(4)(ii). Unless
expected to result in death, an impairment is “severe” if it significantly
limits the claimant’s physical or mental ability to do basic work activities.
20 C.F.R. §§ 404.1521(a); 416.921(a). This impairment must have lasted or
must be expected to last for a continuous period of at least 12 months. 20
C.F.R. §§ 404.1509; 416.909. If the claimant does not have a severe
impairment, the analysis ends. 20 C.F.R. §§ 404.1520(a)(4)(ii);
416.920(a)(4)(ii). If the claimant has a severe impairment, the analysis
proceeds to step three.
3. Does the claimant's severe impairment "meet or equal" one or more of the
impairments listed in 20 C.F.R. Part 404, Subpart P, Appendix 1? If so,
then the claimant is disabled. 20 C.F.R. §§ 404.1520(a)(4)(iii);
416.920(a)(4)(iii). If the impairment does not meet or equal one or more of
the listed impairments, the analysis proceeds to the "residual functional
capacity" ("RFC") assessment.
a. The ALJ must evaluate medical and other relevant evidence to assess
and determine the claimant's RFC. This is an assessment of work-related
activities that the claimant may still perform on a regular and continuing
basis, despite any limitations imposed by his or her impairments. 20
C.F.R. §§ 404.1520(e); 404.1545(b)-(c); 416.920(e); 416.945(b)-(c).
After the ALJ determines the claimant’s RFC, the analysis proceeds to
step four.
4. Can the claimant perform his or her "past relevant work" with this RFC
assessment? If so, then the claimant is not disabled. 20 C.F.R.
§§ 404.1520(a)(4)(iv); 416.920(a)(4)(iv). If the claimant cannot perform his
or her past relevant work, the analysis proceeds to step five.
5. Considering the claimant's RFC and age, education, and work experience,
is the claimant able to make an adjustment to other work that exists in
significant numbers in the national economy? If so, then the claimant is not
disabled. 20 C.F.R. §§ 404.1520(a)(4)(v); 416.920(a)(4)(v); 404.1560(c);
416.960(c). If the claimant cannot perform such work, he or she is disabled.
See also Bustamante v. Massanari, 262 F.3d 949, 954-55 (9th Cir. 2001).
The claimant bears the burden of proof at steps one through four. Id. at 954. The
Commissioner bears the burden of proof at step five. Id. at 953-54. At step five, the
Commissioner must show that the claimant can perform other work that exists in significant
numbers in the national economy, "taking into consideration the claimant’s residual functional
capacity, age, education, and work experience." Tackett v. Apfel, 180 F.3d 1094, 1100 (9th Cir.
1999) (internal citations omitted); see also 20 C.F.R. §§ 404.1566; 416.966 (describing "work
which exists in the national economy"). If the Commissioner fails to meet this burden, the
claimant is disabled. 20 C.F.R. §§ 404.1520(a)(4)(v); 416.920(a)(4)(v). If, however, the
Commissioner proves that the claimant is able to perform other work existing in significant
numbers in the national economy, the claimant is not disabled. Bustamante, 262 F.3d at 954-55;
Tackett, 180 F.3d at 1099.
THE ALJ’S FINDINGS
Applying the above analysis, the ALJ made the following findings:
1. Plaintiff has not engaged in substantial gainful activity since April 16, 2018, the
application date. Tr. 16.
2. Plaintiff has the following severe impairments: right knee degenerative joint disease;
lumbar degenerative disc disease status post-surgery; carpel tunnel syndrome (CTS)
status post carpal tunnel release; and inflammatory arthritis; tinnitus; obesity;
depression and somatic symptom disorder. Tr. 17.
3. Plaintiff does not have an impairment or combination of impairments that meets or
medically equals the severity of one of the listed impairments in 20 CFR Part 404,
Subpart P, Appendix 1. Tr. 17.
4. Plaintiff has the residual functional capacity to perform light work as defined in 20
CFR 404.1567(b) except he can never climb ladders, ropes or scaffolds, but he can
occasionally climb ramps and stairs, stoop, kneel, crouch and crawl and frequently
balance. He can frequently, but not constantly, handle and feel bilaterally. He can
tolerate no exposure to workplace hazards such as unprotected heights and exposed,
moving machinery. He can perform simple, routine tasks and make simple work-
related decisions. He can tolerate occasional changes to work routine and work
processes, but he cannot engage in assembly line work, or work that involves timed
production quotas. Tr. 19.
5. Plaintiff is unable to perform any past relevant work. Tr. 31.
6. Plaintiff was born on December 13, 1967, and was 50 years old, which is defined as
an individual closely approaching advanced age, on the date the application was filed.
Tr. 31.
7. Plaintiff has at least a high school education. Tr. 31.
8. Transferability of job skills is not material to the determination of disability because
using the Medical-Vocational Rules as a framework supports a finding that the
claimant is "not disabled," whether or not the claimant has transferable job skills. Tr.
31.
9. Considering Plaintiff’s age, education, work experience, and RFC, there are jobs that
exist in significant numbers in the national economy that Plaintiff can perform,
including Routing Clerk, Housekeeping Cleaner, and Marker. Tr. 32.
10. Plaintiff was not under a disability, as defined in the Social Security Act, since April
16, 2018, the date the application was filed. Tr. 33.
STANDARD OF REVIEW
The reviewing court must affirm the Commissioner's decision if it is based on the
proper legal standards and the legal findings are supported by substantial evidence in the record.
42 U.S.C. § 405(g); Batson v. Comm'r Soc. Sec. Admin., 359 F.3d 1190, 1193 (9th Cir. 2004);
see also Hammock v. Bowen, 879 F.2d 498, 501 (9th Cir. 1989). "'Substantial evidence' means
'more than a mere scintilla but less than a preponderance,' or more clearly stated, 'such relevant
evidence as a reasonable mind might accept as adequate to support a conclusion.'" Bray v.
Comm'r Soc. Sec. Admin., 554 F.3d 1219, 1222 (9th Cir. 2009) (quoting Andrews v. Shalala, 53
F.3d 1035, 1039 (9th Cir. 1995)). In reviewing the Commissioner's alleged errors, this Court
must weigh "both the evidence that supports and detracts from the [Commissioner's]
conclusions." Martinez v. Heckler, 807 F.2d 771, 772 (9th Cir. 1986). Variable interpretations
of the evidence are insignificant if the Commissioner's interpretation is rational. Burch v.
Barnhart, 400 F.3d 676, 679 (9th Cir. 2005).
If the decision of the Appeals Council is the final decision of the Commissioner,
this Court must review the decision of the Appeals Council to determine whether that decision is
supported by substantial evidence. Howard v. Heckler, 782 F.2d 1484 (9th Cir. 1986). Where
the evidence before the ALJ or Appeals Council is subject to more than one rational
interpretation, the Commissioner's conclusion must be upheld. Batson, 359 F.3d at 1198 (citing
Andrews, 53 F.3d at 1041). "However, a reviewing court must consider the entire record as a
whole and may not affirm simply by isolating a 'specific quantum of supporting evidence.'"
Robbins v. Soc. Sec. Admin., 466 F.3d 880, 882 (9th Cir. 2006) (quoting Hammock, 879 F.2d at
501). Additionally, a reviewing court "cannot affirm the [Commissioner's] decision on a ground
that the [Administration] did not invoke in making its decision." Stout v. Comm’r Soc. Sec.
Admin., 454 F.3d 1050, 1054 (9th Cir. 2006) (citations omitted). Finally, a court may not reverse
the Commissioner's decision on account of an error that is harmless. Id. at 1055-56. "[T]he
burden of showing that an error is harmful normally falls upon the party attacking the agency's
determination." Shinseki v. Sanders, 556 U.S. 396, 409 (2009).
Even where findings are supported by substantial evidence, "the decision should
be set aside if the proper legal standards were not applied in weighing the evidence and making
the decision." Flake v. Gardner, 399 F.2d 532, 540 (9th Cir. 1968). Under sentence four of 42
U.S.C. § 405(g), the reviewing court has the power to enter, upon the pleadings and transcript
record, a judgment affirming, modifying, or reversing the decision of the Commissioner, with or
without remanding the case for a rehearing.
DISCUSSION
Plaintiff presents the following issues for review:
1. Whether the ALJ properly considered Plaintiff's own testimony,
2. Whether the ALJ properly evaluated the medical opinion of Dr. Thomas Brent Shields,
Ph.D.
For the following reasons, the Court finds that the ALJ did not err. The decision of the
Commissioner is affirmed.
I. The ALJ properly considered Plaintiff’s subjective symptom testimony.
Plaintiff challenges the ALJ's treatment of Plaintiff's subjective testimony. Pl.'s
Br. #14 at 8. Plaintiff argues that the reasons the ALJ relied upon to reject Plaintiff's allegations
were not clear and convincing because they were not supported by substantial evidence. Id at 9.
To assess a plaintiff's credibility, the Ninth Circuit is clear that an ALJ must perform a two-stage
analysis. In the first stage, the plaintiff must produce objective medical evidence of one or more
impairments which could reasonably be expected to produce some degree of symptom.
Lingenfelter v. Astrue, 504 F.3d 1028, 1036 (9th Cir. 2007). The plaintiff is not required to show
that the impairment could reasonably be expected to cause the severity of the symptom, but only
to show that it could reasonably have caused some degree of the symptom. Id.
In the second stage of the analysis, the ALJ must consider the intensity,
persistence, and limiting effects of the alleged symptoms based on the entire record. SSR 16-3p
at *7-8. The ALJ will consider the "[l]ocation, duration, frequency, and intensity of pain or other
symptoms reported by the claimant, any medical sources, and any non-medical sources." Id.
The ALJ’s decision must contain "specific reasons for the weight given to the individual's
symptoms, be consistent with and support by the evidence, and be clearly articulated so the
individual and any subsequent reviewer can assess how the adjudicator evaluated the individual's
symptoms." Id. Additionally, the evidence upon which the ALJ relies must be substantial. See
Holohan v. Massinari, 246 F.3d 1195, 1208 (9th Cir. 2001). In rejecting plaintiff's testimony
about the severity of their symptoms, the ALJ must give "specific, clear and convincing reasons
for doing so." Brown-Hunter v. Colvin, 806 F.3d 487, 493 (9th Cir. 2015).
Plaintiff argues the ALJ is bound to the clear and convincing standard used for
rejecting a plaintiff's subjective testimony, however, "the ALJ is not required to believe every
allegation of disabling pain, or else disability benefits would be available for the asking[.]"
Molina v. Astrue, 674 F.3d 1104, 1112 (9th Cir. 2012), superseded on other grounds by 20
C.F.R. § 404.1502(a). If the ALJ's findings are supported by substantial evidence in the record,
[the reviewing court] may not engage in second-guessing. See Morgan v. Comm’r Soc. Sec.
Admin., 169 F.3d 595, 600 (9th Cir. 1999), Fair v. Bowen, 885 F.2d 597 (9th Cir. 1989).
The ALJ reasonably concluded that the evidence in the record was inconsistent
with Plaintiff's allegations regarding his limitations. Plaintiff alleges that he cannot work due to
back, knee, arm, and hand pain, as well as depression and anxiety. Tr. 376. The ALJ found that
Plaintiff's "medically determinable impairments could reasonably be expected to cause some of
the claimant's alleged symptoms." Tr. 21. However, the ALJ found that "the claimant's
statements concerning the intensity, persistence, and limiting effects of these symptoms are not
consistent with the medical evidence and other evidence in the record . . ." Id. The ALJ pointed
to specific evidence in the record, including treatment notes from Sky Lakes Medical in 2018-
2019, an objective report from Dr. Michael Henderson, 2019 X-Ray results, treatment notes from
Samaritan Health Services and Klamath Basin Behavioral Health, a psychological evaluation by
Dr. Thomas Brent Shields, and a musculoskeletal examination by Dr. Mike Henderson.
A. The ALJ properly evaluated Plaintiff's subjective symptom testimony surrounding
his limitations due to back, knee, arm and hand pain.
Specifically, the ALJ found evidence in the record that contradicted Plaintiff’s
claims of almost complete immobility due to pain in his low back, knees, arm and hand. Tr. 375-
406. Reports from Dr. Catherine Ruth note that plaintiff was reluctant to disclose details about
his pain, he had hyperalgesia2 to light touch over is elbow and forearm, normal sensation in his
fingers and 5/5 strength in his hand. Tr. 482. The ALJ also pointed to Dr. Ruth's notes that
Plaintiff had no point tenderness over lumbar spine, but had "tenderness to palpitation over the
bilateral paraspinal muscles, worse on the left side, and a straight leg raising test was positive at
2 Hyperalgesia is a symptom where you feel pain in situations where feeling it is normal, but the pain is much more
severe. It happens because of disruptions in your body’s pain processes. This can happen commonly with burns and
many other injuries and conditions. It’s often treatable, with many possible treatment methods and approaches.
Cleveland Clinic, Hyperalgesia, https://my.clevelandclinic.org/health/symptoms/23550-hyperalgesia (last visited
August 21, 2023).
60 degrees on the left. Range of motion was normal in his lower back, and his left leg sensation
and strength were normal. His gait was also normal. He was prescribed Gabapentin and was
referred to physical therapy." Tr. 21. Plaintiff is correct that the ALJ cited to both "evidence that
supports Plaintiff's allegations and evidence that detracts from it." Pl.'s Br. #14 at 9. However,
the ALJ provided substantial evidence to support his conclusions about Plaintiff's impairments.
"Where evidence is susceptible to more than one rational interpretation, the ALJ's decision
should be upheld." Trevizo, 871 F.3d at 674-75 (citing Orn v. Astrue, 495 F.3d at 625, 630 (9th
Cir. 2007)).
Dr. Henderson's3 physical and neurological examinations both point to instances
of Plaintiff's somatic symptom disorder4. Dr. Henderson's objective data from the physical
examination states the "[e]xam was inconsistent and [plaintiff] had excessive pain behavior . . .
The pain behavior throughout the exam [was] relatively theatrical and drawn out." Tr. 616. The
ALJ cites to this evidence, as well as pointing out plaintiff's ability to stand up from a sitting
position without assistance or evidence of pain, as well as his tandem walking being good and
his "reported diffuse tenderness of his back, but he was vague as to location." Tr. 21. Dr.
Henderson concluded this examination by stating that plaintiff's depression and anxiety is the
main impairment, and that there were several inconsistencies of pain behavior and function for
his back, right arm pain, and knees. Tr. 617. "Right arm pain: The history is vague as to how it
3 Dr. Henderson is an independent medical examiner who did not had previous contact with plaintiff.
4 Somatic symptom disorder is diagnosed when a person has a significant focus on physical symptoms, such as pain,
weakness or shortness of breath, to a level that results in major distress and/or problems functioning. The individual
has excessive thoughts, feelings and behaviors relating to the physical symptoms. The emphasis is on the extent to
which the thoughts, feelings and behaviors related to the illness are excessive or out of proportion. American
Psychiatric Association, What is Somatic Symptom Disorder?, https://www.psychiatry.org/patients-families/somatic-
symptom-disorder/what-is-somatic-symptom-
disorder#:~:text=Somatic%20symptom%20disorder%20is%20diagnosed,relating%20to%20the%20physical%20sy
mptoms (last visited August 21, 2023).
was injured and he talks about cubital tunnel and carpal tunnel, but anatomically this does not
explain the reaction during the exam." Id.
The above medical opinion evidence, paired with the ALJ's half-page recitation of
Dr. Henderson's 2019 neurological examination5, and the ALJ's citation to Plaintiff's 2019
treatment notes from Sky Lakes Medical and Samaritan Health Services6 is more than enough to
satisfy the substantial evidentiary standard. Moreover, the inconsistency between Plaintiff's
reports of debilitating pain and the objective medical findings is something the ALJ can take into
consideration for their ruling. “[T]he ALJ may consider inconsistencies either in the claimant's
testimony or between the testimony and the claimant's conduct . . .” Molina, 674 F.3d at 1112,
Kendel S. v. Comm’r Soc. Sec. Admin., No. C20-5800-MAT, 2021 U.S. Dist. LEXIS 150250, at
*21-22 (W.D. Wash. Aug. 10, 2021). The ALJ did not err in his analysis finding inconsistencies
between Plaintiff's subjective symptom testimony and the objective record, and if there was any
error, such error was harmless.
B. The ALJ properly evaluated Plaintiff's subjective symptom testimony surrounding
his mental health limitations.
Plaintiff argues the medical record supports his allegations of disabling limitations
due to depression. Pl.'s Br. #14 at 11. Plaintiff also argues that the ALJ ignored treatment notes
from mental health providers. Id. at 12. This is an incorrect assessment of the ALJ's opinion.
The ALJ does cite to treatment notes from mental health providers (Dr. Thomas Brent Shields,
Klamath Basin Behavioral Health and a mental health specialist at Samaritan). Tr. 24; see Tr.
5 "The [Plaintiff] withdrew in pain around the medial epicondyle with light pushing of his right elbow, but no
erythema, associated skin swelling or excess moisture consistent with reflex sympathetic dystrophy was present.
Bilateral elbow flexion and extension was normal, with no difficulty with pronation or supination." Tr. 22, 621-23.
6 "In February 2020, the claimant's gait was upright and stable. He had no visible tremors, and his grip strength was
equal. His range of motion was normal, with no edema. X-rays of claimant's right hand showed mild osteoarthritic
changes and an ulnar positive variant." Tr. 23, 894, 898-900 (internal citations omitted).
609-13, 642-44, 1234. The ALJ concluded that "the objective medical evidence of record
regarding [plaintiff's] mental symptoms also support that no more restrictive limitations are
required." Tr. 25. Specifically, the ALJ pointed to several different mental status examinations
where plaintiff's affect is cooperative, pleasant, awake, alert, active and fully oriented, with
appropriate appearance and eye contact, and normal psychomotor activity, behavior, mood
affect, speech, perception, thought process and thought content. Id.
Plaintiff is correct that the ALJ did not mention Dr. Gardner's assessment of
plaintiff's PHQ-9 score being rated as high as 24 (severe depression). Tr. 1349. However,
plaintiff fails to acknowledge the four paragraphs where the ALJ discusses plaintiff's depression,
stress and even his suicidal ideation. See Tr. 24-5. The ALJ did not ignore objective evidence of
plaintiff's reported mental impairments. An ALJ is tasked with resolving conflicts in medical
testimony to make a finding. Ford v. Saul, 950 F.3d 1141, 1149 (9th Cir. 2020) (citing Andrews,
53 F.3d at 1039). "Where the evidence can reasonably support either affirming or reversing a
decision, we [the court] must not substitute our judgment for that of the ALJ." Garrison v.
Colvin, 759 F.3d 995, 1010 (9th Cir. 2014) (internal quotation and brackets omitted). The ALJ
has supported his opinion regarding plaintiff's depression with substantial evidence, as noted
above and elaborated upon earlier in his opinion. See Tr. 18-19. Specifically, the ALJ found
that the "severity of [plaintiff's] mental impairments, considered singly and in combination, do
not meet or medically equal the criteria of listings 12.047 and 12.068." Id. To support this
finding, the ALJ utilized plaintiff's function report to note that "he has the mental capacity to
complete such tasks as driving, attending to his personal hygiene, paying bills, grocery shopping
and completing light household chores . . . The claimant has reported that he has problems
7 12.04 Depressive, bipolar and related disorders.
8 12.06 Anxiety and obsessive-compulsive disorders.
getting along with others. However, he also reported he does spend time with others particularly
with his family and his girlfriend, and he admits that he has never been fired or laid off from a
job because of problems getting along with other people." Id. (internal citations omitted).
Plaintiff argues the ALJ ignored plaintiff's qualifying explanations for those activities. Pl.'s Br.
#14 at 14. However, the ALJ acknowledged plaintiff's qualifying explanation that he could only
do light household chores, which the ALJ then accounted for in the RFC. There are two ways
activities of daily living (ADLs) may support a rejection of subjective symptom testimony: (1)
the ADLs contravene the claimant's allegations of functional limitations; or (2) the ADLs "meet
the threshold for transferrable work skills[.]" Orn, 495 F.3d at 639. "Even where those activities
suggest some difficulty functioning, they may be grounds for discrediting the [plaintiff's]
testimony to the extent that they contradict claims of a totally disabling impairment." Molina,
674 F.3d at 1113. Such is the case here. Plaintiff alleges he is in bed 15 days of the month due
to completely disabling symptoms from back, knee, arm and hand pain. Tr. 78-9. However, the
ALJ found that plaintiff's aforementioned activities contradict claims of total disability, and the
Court agrees. "Some of the physical and mental abilities and social interactions required in order
to perform these activities are the same as those necessary for obtaining and maintaining
employment." Tr. 26.
In conclusion, the ALJ reasonably found plaintiff's subjective testimony regarding
the frequency and severity of his depression to be inconsistent with the medical evidence, and the
ALJ's reasoning was specific, clear, and convincing.
II. The ALJ properly evaluated and credited the medical opinions of Dr. Thomas
Brent Shields, Ph.D.
Under prior Social Security regulations, a hierarchy of medical opinions dictated
the weight that must be given by an ALJ: treating doctors were generally given the most weight
and non-examining doctors were generally given the least weight. See 20 C.F.R. §§ 404.1527,
416.927 (1991); 56 Fed. Reg. 36,932 (Aug. 1, 1991). For applications filed on or after March
27, 2017, the new regulations eliminate the old hierarchy of medical opinions. 20 C.F.R. §§
404.1520c(a), 416.920c(a) (2017). Plaintiff filed an application for disability insurance benefits
on April 16, 2018. Thus, the Commissioner's new regulations apply to the ALJ’s assessment of
this opinion. See 20 C.F.R. § 404.1520c; 82 Fed. Reg. 5844 (Jan. 18, 2017); see also 82 Fed.
Reg. 15,132 (Mar. 27, 2017) (correcting technical errors).
The new rules no longer provide for any inherent weight: "We [the SSA] will not
defer or give any specific evidentiary weight, including controlling weight, to any medical
opinion(s) or prior administrative medical finding(s) including those from your medical sources."
20 C.F.R. §§ 404.1520c(a), 416.920c(a). The SSA "considers" various medical opinions for
claims filed on or after March 27, 2017, and determines which medical opinions are most
persuasive. 20 C.F.R. §§ 404.1520c(a), 416.920c(a). In evaluating which opinions are most
persuasive, the ALJ considers several factors. The two most important factors are supportability
& consistency. Id. Secondary factors include the relationship with the claimant, specialization,
and other factors. Id. at 404.1520c(c), 416.920c(c).
Plaintiff contends that the ALJ did not properly consider the factors of
supportability and consistency in evaluating the opinions of Dr. Shields. Plaintiff is incorrect,
and the ALJ did not commit harmful error. Regarding the aforementioned factors of
supportability and consistency, the definitions are as follows:
Supportability: the "more relevant the objective medical evidence
and supporting explanations presented by a medical source," the
more persuasive that medical opinion will be.
20 C.F.R. § 404.1520c(c)(1).
Consistency: the "more consistent a medical opinion" is with "the
evidence from other medical sources and nonmedical sources in the
claim, the more persuasive the medical opinion" will be.
20 C.F.R. § 404.1520c(c)(2).
Plaintiff supports his argument by stating "[t]he ALJ cited to a number of mental status exam
notes made by non-mental health professionals in the course of treatment for physical conditions
to find that Dr. Shields' medical opinions was undermined by other evidence in the record." Pl.'s
Br. #14 at 16-7. The Court agrees with the Commissioner that there are no regulations
preventing an ALJ from considering opinions regarding plaintiff's mental health from non-
mental health professionals. The Court has already discussed the new medical rules that an ALJ
must follow in evaluating medical opinions, and will not do so again here. Ultimately, the ALJ
is responsible for determining which medical opinions are most persuasive. 20 C.F.R. §§
404.1520c(a), 416.920c(a).
Here, the ALJ weighed evidence from Dr. Shields that both supported and
detracted from plaintiff's claims. The ALJ found that his opinion was "mostly persuasive." Tr.
30. Plaintiff is correct that the ALJ cited to mental status exam notes entered during the course
of treatment for his physical conditions. Pl.'s Br. #14 at 16. However, the occasion as to why
those mental status exam notes were taken is immaterial to the ALJ's determination of plaintiff's
mental health status. The ALJ is instructed and encouraged to view the entirety of the record.9
What is more, the ALJ discussed both factors of supportability and consistency10 as required, and
9 The ALJ must consider the medical record as a whole, rather than isolating a "specific quantum" of evidence to
support the ALJ’s conclusion. Gallant v. Heckler, 753 F.2d 1450, 1455 (9th Cir. 1984); see also Holohan v.
Massanari, 246 F.3d 1195, 1205-08 (9th Cir. 2001) (cherry-picking is improper).
10 "It is supported by Dr. Shields' findings of slow, monotonous and occasionally slurred speech, depressed mood
with blunted affect, withdrawn demeanor, distractibility and slow processing speed, and by his observation that the
claimant was depressed, unmotivated and fatigued. In addition, Dr. Shield's opinion is consistent with other findings
of distractibility, significant difficulty performing a serial seven exercise, circumstantial thought processes and the
need for redirection." Tr. 30 (internal citations omitted).
cogently concluded that plaintiff would be able to perform simple, routine tasks as detailed in the
RFC, despite his mental impairments. Tr. 30. Moreover, so long as the ALJ's findings represent
a reasonable interpretation of the evidence, the Court must uphold them. "[I]f evidence exists to
support more than one rational interpretation, we must defer to the Commissioner's decision[.]"
Batson v. Comm’r of Soc. Sec. Admin., 359 F.3d 1193 (9th Cir. 2004). The ALJ's analysis is
supported by substantial evidence. The ALJ’s decision is affirmed.
ORDER
The ALJ did not err. The decision is AFFIRMED.
It is so ORDERED and DATED this 24th day of August, 2023.
Jd s le Lor 2
Adrienne Nelson
United States District Court Judge
15 - Opinion and Order