Del Pape v. Commissioner Social Security Administration

UNITED STATES DISTRICT COURT

DISTRICT OF OREGON

SCOTT RYAN D., Ca se No. 1:22-cv-01845-AR

Plaintiff, OPINION AND ORDER

v.

COMMISSIONER SOCIAL SECURITY

ADMINISTRATION,

Defendant.

_____________________________________

ARMISTEAD, Magistrate Judge

In this judicial review of the Commissioner’s final decision denying Social Security

benefits, Scott Ryan D. (last name omitted for privacy) challenges the Administrative Law

Judge’s evaluation of the medical opinions from Karla Reinhart, DNP, FNP-C, his subjective

symptom testimony, and of lay witness testimony. Pl. Br. at 5, ECF No. 14. As explained below,

the Commissioner’s decision is AFFIRMED.1

1 This court has jurisdiction under 42 U.S.C. §§ 405(g) and 1383(c)(3), and all parties have

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ALJ’S DECISION

In denying plaintiff’s application for Title XVI Supplemental Security Income (SSI), the

ALJ followed the five-step sequential evaluation process.2 The ALJ determined that plaintiff had

a severe psychological impairment (dysthymia) and severe physical impairments (chronic kidney

disease stage 3; asthma/chronic obstructive pulmonary disease (COPD); and keratoconus). (Tr.

18.) Plaintiff reported an inability to work because of chronic fatigue that “causes [him] to sleep

more than the average person,” his impaired kidney function, and difficulty breathing caused by

COPD. (Tr. 478-84, 817, 809.)

As to the RFC, the ALJ considered the evidence in the case record and found that

plaintiff’s medically determinable impairments explained some of his symptoms but that the

medical evidence and his reports of daily living were not entirely consistent with his statements

concerning the intensity, persistence, and limiting effects of his alleged symptoms. (Tr. 22.)

Notably, the ALJ considered the extent to which plaintiff could care for his elderly in-laws,

perform household chores, drive, grocery shop, spend time with his partner, and play video

games. (Tr. 21.)The ALJ also explained that plaintiff’s symptoms were stable, did not interfere

with his daily activities, and were properly managed with treatment. (Tr. 21-23.) Given those

findings, the ALJ found that plaintiff was capable of performing less than a full range of

sedentary work with the following additional limitations:

consented to jurisdiction by magistrate judge under Federal Rule of Civil Procedure 73 and 28

U.S.C. § 636(c).

2 To determine a claimant’s disability, the ALJ must apply a five-step evaluation. See 20

C.F.R. §§ 404.1520(a)(4), 416.920(a)(4). If the ALJ finds that a claimant is either disabled or not

disabled at any step, the ALJ does not continue to the next step. Id.; see also Parra v. Astrue, 481

F.3d 742, 746–47 (9th Cir. 2007) (discussing the five-step evaluation in detail).

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occasional climbing of ramps and stairs; never climbing ladders, ropes, or

scaffolds; occasional stooping, kneeling, crouching, and crawling; avoid

concentrated exposure to extreme cold; no exposure to fumes, odors, dusts, gases,

poor ventilation, etc.; no exposure to hazards such as unprotected heights;

limitation to simple, routine, repetitive tasks consistent with a reasoning level of 2

and unskilled work as defined by the DOT; and limitation to no more than

occasional contact with the general public.

(Tr. 20.) With that RFC, the ALJ determined that there are jobs that exist in significant numbers

in the national economy that plaintiff can perform, such as laminator, final assembler, and

addresser.3 (Tr. 26.)

DISCUSSION

The district court must affirm the Commissioner’s decision if the Commissioner applied

proper legal standards and the findings are supported by substantial evidence in the record. 42

U.S.C. § 405(g); Ford v. Saul, 950 F.3d 1141, 1154 (9th Cir. 2020). Substantial evidence is

“more than a mere scintilla” and is “such relevant evidence as a reasonable mind might accept as

adequate to support a conclusion.” Biestek v. Berryhill, 139 S. Ct. 1148, 1154 (2019) (quotation

and citation omitted). To determine whether substantial evidence exists, the court must weigh all

the evidence, whether it supports or detracts from the Commissioner’s decision. Garrison v.

Colvin, 759 F.3d 995, 1009 (9th Cir. 2014). Plaintiff advances three arguments challenging the

ALJ’s decision, and the court, mindful of the standard of review, addresses each in turn.

A. Karla Reinhart’s Medical Opinion

3 As noted in White v. Kijakazi, 44 F.4th 828, 835 (9th Cir. 2022), the SSA has been

working on a transition to a new Occupational Information System since 2008. The transition has

not yet occurred, and the Ninth Circuit has encouraged the SSA, along with its sister circuits, “to

make the transition to a system that more accurately reflects available jobs in the current

economy.” Id.

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The ALJ noted Reinhart’s opinion in which she stated that plaintiff would need to lie

down or rest periodically because of fatigue, kidney disease, and COPD. (Tr. 23, 1056-59.) The

ALJ also acknowledged Reinhart’s statements that plaintiff would need two to four unscheduled

breaks daily for 10 to 15 minutes due to fatigue and dyspnea, and would be absent three to four

days per month. (Tr. 23, 1058-59). The ALJ, however, found that opinion unpersuasive because

Reinhart’s treatment notes do not reflect significant abnormalities to support the assessed degree

of restriction. The ALJ points out that at plaintiff’s first of two visits with Reinhart, he reported

fatigue, insomnia, and dyspnea. Yet Reinhart noted plaintiff’s “lungs were clear to auscultation

bilaterally and his strength was full throughout the major muscle groups.” (Tr. 24.) The ALJ

relies on this to conclude that the “records fail to show why he would need unscheduled breaks,

excessive absences, and be unable to sit for longer periods.” (Tr. 24, see Tr. 1049-54, 1142-53.)

The ALJ also notes that rather than provide what symptoms the claimant experienced, Reinhart

cited the diagnostic codes in her first opinion and did not respond to the question asking how

long plaintiff would need to rest during the day. (Tr. 23, see Tr. 1055-59.) The ALJ explained

that, even after reviewing Reinhart’s second opinion completed in 2021, plaintiff’s conditions

had not changed and that they remained stable. (Tr. 24, citing Tr. 1154-55.) Taken together, the

ALJ found Reinhart’s opinions unpersuasive and concluded that there were “very little objective

findings or signs in the record to support her opinion.” (Tr. 24.)

Plaintiff asserts that by finding unpersuasive Reinhart’s two medical opinions, the ALJ

erroneously evaluated his stage 3 Chronic Kidney Disease (CKD) and its most limiting symptom

– chronic fatigue. Plaintiff questions whether the ALJ considered each of Reinhart’s opinions

individually, when he should have “considered the medical opinions . . . together in a single

analysis.” (Pl.’s Br. at 7, ECF No. 14, citing 20 C.F.R. § 416.920c(b)(1).) In plaintiff’s view, the

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ALJ erred by declining to consider his chronic fatigue as a symptom of his CKD, and instead

rejected his “complaints of . . . chronic fatigue,” because “the medical record does not reflect

associated diagnoses or testing to establish diagnoses” at step two. (Tr. 18.) Plaintiff asserts that

had the ALJ considered Reinhart’s opinions together, the ALJ would have recognized that his

chronic fatigue supports Reinhart’s assessed limitations. (Pl. Br. at 8-9.)

The Commissioner responds that the ALJ appropriately applied the new regulations when

considering Reinhart’s opinion. Under the new regulations, the most important factors an ALJ

must evaluate are (1) supportability and (2) consistency. Woods v. Kijakazi, 32 F.4th 785, 792

(9th Cir. 2022). The Commissioner argues that the ALJ appropriately considered the

supportability and consistency factors to find Reinhart’s opinions not persuasive, that the ALJ’s

rationale is supported by substantial evidence, and that there is no error. The Commissioner is

correct.

Although the ALJ discussed Reinhart’s September 2020 opinion and November 2021

opinion in separate paragraphs, it does not follow that the ALJ failed to analyze them collectively

or that the ALJ disregarded plaintiff’s chronic fatigue symptoms. When discussing Reinhart’s

September 2020 opinion, the ALJ found that the limitations assessed by Reinhart are not

supported by her own treatment notes. (Tr. 23-24.) The ALJ noted that Reinhart had only treated

plaintiff twice before providing the September 2020 opinion, and that her treatment notes “do not

reflect significant abnormalities to support the assessed degree of restriction.” The ALJ detailed

that despite plaintiff’s complaints of fatigue, insomnia, and dyspnea, his lungs were clear to

auscultation bilaterally, and that he had full strength. (Tr. 24.)

The ALJ’s findings are supported by substantial evidence and are a reasonable

interpretation of the record. Contrary to plaintiff’s suggestion, Reinhart’s treatment notes do not

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specifically attribute plaintiff’s fatigue to CKD, and instead are largely unremarkable. The May

2020 treatment notes cited by the ALJ reflect generalized complaints of fatigue, malaise,

lethargy, and insomnia, yet his physical examination findings are benign, with 5/5 strength in all

muscle groups and intact reflexes. (Tr. 1050.) And Reinhart’s August 2020 treatment notes

reflect that plaintiff denied fatigue yet complained of dyspnea, with full strength, normal range of

motion, and no significant examination findings. (Tr. 1051-52.) Based on these routine findings,

the ALJ reasonably could conclude that the severity of the restrictions assessed by Reinhart were

not supported by her own examination findings.

The ALJ also discussed Reinhart’s November 2021 opinion. As the ALJ reported, in

Reinhart’s November 2021 opinion, she stated that she performed plaintiff’s annual exam that

month; that he receives treatment for low vitamin D, high triglycerides, COPD, and depression;

and that his conditions were unchanged, and he remained stable. The ALJ stated that Reinhart’s

November 2021 assessment of plaintiff’s limitations remained the same. The ALJ also observed

that Reinhart’s treatment notes contain “very little objective findings or signs” to support her

limitations. (Tr. 24.) Based on plaintiff’s unchanged, stable conditions and benign examination

findings, the ALJ concluded that Reinhart’s opinion is not persuasive. Reinhart’s treatment notes

reflect conflicting reports of fatigue, and based on her generally unremarkable physical findings,

the ALJ reasonably could conclude that they do not support the severe restrictions listed in her

opinions. The ALJ’s findings concerning the November 2021 opinion are supported by

substantial evidence and are a reasonable interpretation of the record. (Tr. 1052, see also Tr.

1049-54, 1142-53.)

As for consistency, the ALJ had only one other medical opinion to consider alongside

Reinhart’s, that of Kumar Dinesh, M.D., a renal care specialist. The ALJ stated that Dr. Dinesh

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acknowledged plaintiff’s fatigue, but could not assess whether that was due to his kidney disease

or medications. (Tr. 24, citing Tr. 1097.) The ALJ also noted that Dr. Dinesh observed that

plaintiff’s CKD has been stable from 2014 to 2021, citing his creatinine levels, which the ALJ

found consistent with his other treatment records, and that Dr. Dinesh did not assess plaintiff’s

functional limitations. (Tr. 24.) Though plaintiff would have the court reweigh evidence, the ALJ

is ultimately “responsible for . . . resolving conflicts in medical testimony,” not the reviewing

court. E.g., Ford v. Saul, 950 F.3d 1141, 1149 (9th Cir. 2020). Because substantial evidence

supports the Commissioner’s rational interpretation, it must be upheld. Batson v. Comm’r of the

Soc. Sec. Admin., 359 F.3d 1190, 1193 (9th Cir. 2004); Biestek v. Berryhill, 139 S.Ct. 1148, 1154

(2019).

Plaintiff’s other arguments about the ALJ finding Reinhart’s opinion unpersuasive are

also unavailing. He asserts that the ALJ did not explain how Reinhart’s findings that plaintiff’s

“lungs were clear to auscultation bilaterally and his strength was full throughout the major

muscle groups” were relevant to plaintiff’s fatigue. Plaintiff argues that by using that objective

finding, the ALJ erroneously concluded that his “records fail to show why he would need

unscheduled breaks, excessive absences, and be unable to sit for longer periods.” (Pl.’s Br. at 9.)

It was not unreasonable for the ALJ to conclude that Reinhart’s medical opinions were

unsupported considering the nature of her responses to the questionnaire. Reinhart’s responses

were brief, conclusory, and were inadequately supported by objective clinical findings. As the

ALJ pointed out, she did not provide a full response to question seven (concerning how long

[plaintiff] would need to lie down or rest during the day), some inquiries were “not assessed,”

and some responses only referred to the “dx codes.” (Tr. 23, see Tr. 1055-59.) “Although we [the

reviewing court] will not fault the agency merely for explaining its decision with less than ideal

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clarity, we still demand that the agency set forth the reasoning for its decision in a way that

allows for meaningful review.” Brown-Hunter v. Colvin, 806 F.3d 487, 493 (9th Cir. 2015)

(internal citation and quotation marks omitted). The court can conduct a meaningful review of

the ALJ’s opinion, as his logic is clear based on the lack of objective findings and responses

from Reinhart herself. As noted above, the ALJ reasonably concluded that plaintiff’s symptoms

were not totally disabling because the only available objective findings logically discredit his

chief complaints of trouble breathing and chronic fatigue. Therefore, the ALJ reasonably

concluded that Reinhart’s opinions that plaintiff would need unscheduled breaks, be absent from

work three to four time per month, and be unable to sit for long periods of time as unsupported.

(Tr. 24, 1052.) The ALJ did not err in evaluating Reinhart’s opinions.

B. Subjective Symptom Testimony

Plaintiff argues that the ALJ improperly rejected his subjective symptom testimony. In

his view, the ALJ failed to articulate specific, clear and convincing findings in discounting his

symptom testimony. Plaintiff maintains, contrary to the findings of the ALJ, that the RFC does

not allow for the frequent breaks, daily naps, constant reminders to stay on task, and frequent

absences to which he testified. Plaintiff also objects to the ALJ’s conclusion that his allegations

of the level of symptoms and limitations he experiences are inconsistent with his medical record.

Plaintiff lastly asserts his activities of daily living do not exceed his alleged limitations, as the

ALJ found. As the court explains, the ALJ’s findings were sufficiently specific, clear and

convincing.

To determine whether a claimant’s testimony about subjective pain or symptoms is

credible, an ALJ must perform two stages of analysis. Trevizo v. Berryhill, 871 F.3d 664, 678

(9th Cir. 2017); 20 C.F.R. § 416.929. The first stage is a threshold test in which the claimant

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must produce objective medical evidence of an underlying impairment that could reasonably be

expected to produce the symptoms alleged. Treichler v. Comm’r Soc. Sec. Admin., 775 F.3d

1090, 1102 (9th Cir. 2014); Tommasetti v. Astrue, 533 F.3d 1035, 1039 (9th Cir. 2008). At the

second stage, absent affirmative evidence that the claimant is malingering, the ALJ must provide

clear and convincing reasons for discounting the claimant’s testimony about the severity of her

symptoms. Carmickle v. Comm’r Soc. Sec. Admin., 533 F.3d 1155, 1160 (9th Cir. 2008);

Lingenfelter v. Astrue, 504 F.3d 1028, 1036 (9th Cir. 2007). The ALJ must make findings that

are specific enough to permit the reviewing court to conclude that the ALJ did not arbitrarily

discredit the claimant’s testimony. Brown-Hunter, 806 F.3d at 493. Factors the ALJ may

consider when making those credibility determinations include the objective medical evidence,

the claimant’s treatment history, the claimant’s daily activities, and inconsistencies in testimony.

Ghanim v. Colvin, 763 F.3d 1154, 1163 (9th Cir. 2013); Tommasetti, 533 F.3d at 1039.

At both of his hearings and in function reports, plaintiff alleged that he cannot work

because of constant fatigue, kidney disease, and COPD from chronic asthma. (Tr. 48-50, 79-81,

478-484, 817, 809.) He reported he would be unable to work because he would miss too many

days, that he has been using inhalers all of his life, tires quickly with exertion, and suspects his

symptoms will not improve. (Tr. 48-49.) At his 2021 hearing, plaintiff testified that he is out of

breath all the time, but can prepare simple meals, do laundry, wash dishes and grocery shop. (Tr.

51-53.) Plaintiff also testified that he went to the hospital in September 2021 because of fatigue,

tingling on the right side of his body, and lethargy due to his CKD and COPD. (Tr. 54.)

The ALJ made no finding of malingering and determined that plaintiff provided objective

medical evidence of underlying impairments which might reasonably produce the symptoms

alleged. (Tr. 22.) Even so, the ALJ discounted the alleged severity, intensity, and persistence of

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plaintiff’s symptom testimony as (1) inconsistent with his reported activities of daily living and

(2) inconsistent with evidence showing improvement and stability with treatment. (Tr. 22-24.)

Plaintiff contends that neither reason is supported by substantial evidence. The court disagrees.

Turning to the first rationale, the ALJ appropriately found plaintiff’s symptom testimony

inconsistent with his reported activities. (Tr. 22-23); Garrison, 759 F.3d at 1016 (stating that a

claimant’s activities have “bearing on [his] credibility” if the reported “level of activity” is

“inconsistent with [the claimant’s] claimed limitations”). Plaintiff reported that during a typical

day, he will do laundry, pick up around the house, take out the garbage, go grocery shopping,

spend time with his girlfriend and her parents, watch TV, drive, prepare meals, take naps, and

play video games. (Tr. 479-84.) Most notably, plaintiff testified that he served as a caregiver for

his girlfriend’s parents in 2018 – who had substantial health and mobility issues and needed “24

hour care . . . making it hard for [him] as [a caregiver] to focus on self care.” (Tr. 22, 83-84, 682,

973, 1031.) In this role, plaintiff lived with both in-laws, drove them to their doctor’s

appointments, picked up around the house when needed, and completed their shopping. (Tr. 76-

78.)

The ALJ found plaintiff’s reports that he cannot work due to his constant fatigue and

difficulty breathing inconsistent with these activities. The ALJ pointed to reports from plaintiff

that he sleeps more than average, but that eight to nine hours of sleep was sufficient. (Tr. 22,

citing 479, 946-47, 937.) The ALJ noted that plaintiff’s need for extra sleep would not preclude

average daytime work activity. (Tr. 22.) The ALJ also stated, “I find [his] allegations of

debilitating symptoms and inability to perform any work activity is inconsistent with his multiple

references that he provides full-time care for his elderly in-laws.” (Tr. 22.) Plaintiff argues that

the record does not establish that his role in helping his in-laws exceed his alleged limitations.

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Plaintiff argues that he never provided “full-time” care for his in-laws and that his partner did

most of the caregiving. (Pl.’s Br. at 14, citing Tr. 76-77, 83.) But as correctly cited by the ALJ,

the record reveals that plaintiff was a full-time caregiver several times. (Tr. 22, citing Tr. 1031,

479, 943, 946, 973.) These findings are fully supported by substantial evidence in the record.

Thus, the ALJ reasonably concluded that plaintiff’s claim of a complete inability to perform any

work activity was inconsistent with his caregiving role. Based on the nature and duration of care

plaintiff provided for his in-laws during the relevant period, the ALJ reasonably could find that

his daily activities are inconsistent with his allegations of total disability and rationally discount

his allegations on that basis.

Turning to the ALJ’s second rationale, the court disagrees with plaintiff that the ALJ

summarized objective medical findings related to his COPD/asthma and CKD to discredit his

testimony. He argues that the ALJ identified “no evidence to show that the ‘mildness’ of his

airway obstruction could not cause his alleged shortness of breath.” (Pl.’s Br. at 14.) Plaintiff

also asserts that simply because his CKD condition is “stable” does not mean that it has

improved.

The ALJ discounted plaintiff’s subjective symptom testimony finding that his physical

symptoms conflict with medical evidence showing improvement and stability with treatment.

The treatment improvements that the ALJ relies on “constitute examples of a broader

development to satisfy the applicable ‘clear and convincing’ standard.” Garrison, 759 F.3d at

1018. For instance, the ALJ noted that despite plaintiff’s reports of significant fatigue and

difficulty breathing, throughout his medical record he regularly reported good response to

treatment, his providers regularly commented on his stable conditions and mild findings on his

pulmonary function testing. (Tr. 22, citing 1035, 1037, 670-75.) And the ALJ points to plaintiff’s

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allegation that he might need to be put on oxygen but failed to find evidence of such need in the

record. Contrary to plaintiff’s assertions, the ALJ discussed evidence from his pulmonary

specialist, Diya Mohammad, M.D., who considered plaintiff’s asthma as mild, persistent, and

well-controlled, requiring no change in treatment. (Tr. 22, citing Tr. 1030.) The ALJ also noted

improvement in his asthma as of the amended alleged onset date and positive respiratory

examination findings, with 97 % oxygen saturation. (Tr. 22, citing Tr. 664, 670-75, 1049-54,

1142-53.) Lastly, the ALJ points out that plaintiff has not been referred to pulmonology, his

inhalation medications have not been changed, he denies difficulty speaking due to his

COPD/asthma, and has reported that his inhaler improves his breathing. (Tr. 22, citing Tr. 1143.)

As to plaintiff’s CKD, the ALJ found his incurable condition to be stable. (Tr. 22.)

Despite his reported pain from this disease, the ALJ discussed treatment notes where he told his

providers he was experiencing “mild” pain, but that such pain would not “result in functional

limitations greater than what would be addressed by a sedentary residual functional capacity.”

(Tr. 22, citing Tr. 497-499, 969-1023, 1060-68.) The ALJ also detailed how his CKD is regularly

monitored, and that his kidney functioning has been consistent over time, “without episodes of

renal failure or other complications such as hyperkalemia, treatment for decreased urine output,

fluid retention causing lower extremity swelling, significant weight loss, nausea, fever, or

associated conditions such as poorly controlled hypertension.” (Tr. 23, citing Tr. 682-780, 968-

1023, 1060-68, 1079-95.) The ALJ also addressed plaintiff’s 2021 emergency room visit. The

ALJ discussed that the record showed plaintiff presented with multiple “vague complaints,

including feeling weak and fatigued.” (Tr. 23, citing Tr. 1118-23.) Looking to the record, the

physician who treated plaintiff during the emergency room visit stated “[h]is symptoms are

somewhat vague and seem to support a likely viral process. . . Unclear etiology of the patient’s

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symptoms however I see no evidence of acute medical or surgical emergency requiring

hospitalization.” (Tr. 1123.) Thus, the ALJ was justified in relying on plaintiff’s sustained

symptom improvements and generally benign medical examination findings as a basis to

discount the severity of his alleged physical symptoms. The record shows that the ALJ’s

assessment is reasonable and that each reason is supported by substantial evidence. See Thomas

v. Barnhart, 278 F.3d 947, 954 (9th Cir. 2002) (“Where the evidence is susceptible to more than

one rational interpretation, one of which supports the ALJ’s decision, the ALJ’s conclusion must

be upheld.”). Taken together, the ALJ’s reasons provide a specific, clear and convincing basis to

discredit plaintiff’s subjective symptom testimony and the ALJ did not err.

C. Lay Witness Testimony

Plaintiff’s mother submitted a third-party function report and a letter on his behalf. (Tr.

486-93, 535-538.) In her letter, plaintiff’s mother alleged that plaintiff has trouble keeping a job

because he would call in sick too often, he is extremely tired all the time, sleeps a lot, and that

any task takes him much longer than it would for a “normal person.” (Tr. 536-538.) In her report,

she states that she visits him every two to three months, has chronic pain in his lower back due to

his kidneys and Kyposis, runs out of breath easily, and is extremely tired all the time. (Tr. 486.)

She says he “[c]annot go without his medications and inhalers,” and that he has “always been

disabled.” (Tr. 487-88.)

Plaintiff argues that the ALJ failed to provide germane reasons to discount his mother’s

testimony. See Dodrill v. Shalala, 12 F.3d 915 (9th Cir. 1993) (“If the ALJ wishes to discount

the testimony of the lay witnesses, [the ALJ] must give reasons that are germane to each

witness.”).

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Lay witness testimony about a claimant’s symptoms is competent evidence that an ALJ

must consider unless she “expressly determines to disregard such testimony and gives reasons

germane to each witness for doing so.” Lewis v. Apfel, 236 F.3d 503, 511 (9th Cir. 2001). An

exception to the rule applies, however, “[w]here lay witness testimony does not describe any

limitations not already described by the claimant, and the ALJ’s well-supported reasons for

rejecting the claimant’s testimony apply equally well to the lay witness testimony.” Molina v.

Astrue, 674 F.3d 1104, 1118-19; see also Valentine v. Comm’r Soc. Sec. Admin., 574 F.3d 685,

694 (9th Cir. 2009) (“In light of our conclusion that the ALJ provided clear and convincing

reasons for rejecting [the claimant’s] own subjective complaints, and because [the claimant’s

wife’s] testimony was similar to such complaints, it follows that the ALJ also gave germane

reasons for rejecting her testimony.”).

The symptoms testified to by plaintiff's mother are largely consistent with plaintiff's own

testimony. As explained above, the court has determined the ALJ properly discounted that

testimony with clear and convincing reasons supported by substantial evidence. Under Ninth

Circuit precedent, those reasons apply with equal force to discount the lay witness statement

from plaintiff's mother in this context. The ALJ therefore did not err.

CONCLUSION

For the reasons stated above, the court AFFIRMS the Commissioner’s final decision, and

this action is DISMISSED.

DATED January 11, 2024.

NiFF ARWMISTEAD

United States Magistrate Judge

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