Moorman v. Commissioner Social Security Administration

IN THE UNITED STATES DISTRICT COURT

FOR THE DISTRICT OF OREGON

ALAN M., Case No. 6:24-cv-00784-SB

Plaintiff,1 OPINION AND ORDER

v.

COMMISSIONER SOCIAL SECURITY

ADMINISTRATION,

Defendant.

BECKERMAN, U.S. Magistrate Judge.

Alan M. (“Plaintiff”) filed this appeal challenging the Commissioner of Social Security’s

(“Commissioner”) denial of his application for Disability Insurance Benefits (“DIB”) under Title

II of the Social Security Act. The Court has jurisdiction over this matter pursuant to 42 U.S.C.

§§ 405(g) and 1383(c), and the parties have consented to the jurisdiction of a magistrate judge

pursuant to 28 U.S.C. § 636(c). For the reasons explained below, the Court affirms the

Commissioner’s decision.

1 In the interest of privacy, this opinion uses only the first name and initial of the last

name of the non-governmental party.

STANDARD OF REVIEW

“As with other agency decisions, federal court review of social security determinations is

limited.” Treichler v. Comm’r of Soc. Sec. Admin., 775 F.3d 1090, 1098 (9th Cir. 2014). That is

so because “[f]or highly fact-intensive individualized determinations like a claimant’s

entitlement to disability benefits, Congress places a premium upon agency expertise, and, for the

sake of uniformity, it is usually better to minimize the opportunity for reviewing courts to

substitute their discretion for that of the agency.” Id. (quoting Consolo v. Fed. Mar. Comm’n,

383 U.S. 607, 621 (1966)). Adhering to this principle, courts “follow three important rules” in

reviewing social security determinations. Brown-Hunter v. Colvin, 806 F.3d 487, 492 (9th Cir.

2015).

First, courts “leave it to the [agency] to determine credibility, resolve conflicts in the

testimony, and resolve ambiguities in the record.” Id. (quoting Treichler, 775 F.3d at 1098).

Second, courts “will ‘disturb the Commissioner’s decision to deny benefits only if it is not

supported by substantial evidence or is based on legal error.’” Id. (quoting Treichler, 775 F.3d at

1098). Third, if the agency “‘commits legal error, [courts] uphold the decision where that error is

harmless,’ meaning that ‘it is inconsequential to the ultimate nondisability determination,’ or

that, despite the legal error, ‘the agency’s path may reasonably be discerned, even if the agency

explains its decision with less than ideal clarity.’” Id. (quoting Treichler, 775 F.3d at 1098); see

also Smith v. Kijakazi, 14 F.4th 1108, 1111 (9th Cir. 2021) (“And even where this modest

[substantial evidence] burden is not met, [courts] will not reverse an [agency] decision where the

error was harmless.” (citing Molina v. Astrue, 674 F.3d 1104, 1111 (9th Cir. 2012), superseded

on other grounds by regulation as recognized in Farlow v. Kijakazi, 53 F.4th 485, 487 (9th Cir.

2022))).

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BACKGROUND

I. PLAINTIFF’S APPLICATION

Plaintiff was born in March 1962, making him fifty-five years old on October 17, 2017,

his amended alleged disability onset date.2 (Tr. 38.) Plaintiff has at least a high school education

and past work experience as a quality assurance analyst. (Id.) In his DIB application, Plaintiff

alleged disability due to psoriatic arthritis, hypertension, osteoarthrosis foot, eczema, cellulitis of

finger, acute renal failure, depression, spinal stenosis, post-traumatic stress disorder, and gouty

arthritis. (Id. at 205.)

The Commissioner denied Plaintiff’s DIB application initially and upon reconsideration,

and on March 17, 2022, Plaintiff requested a hearing before an Administrative Law Judge

(“ALJ”). (Id. at 84, 90, 113.) On August 2, 2023, Plaintiff, along with his attorney and an

impartial vocational expert (“VE”), appeared and testified at an administrative hearing held

before an ALJ. (Id. at 45.) On September 28, 2023, the ALJ issued a written decision denying

Plaintiff’s application. (Id. at 39.) On October 5, 2023, Plaintiff’s counsel requested the Appeals

Council’s review of the ALJ’s decision. (Id. at 177-78.) On March 13, 2024, the Appeals Council

denied Plaintiff’s request for review making the ALJ’s decision the final decision of the

Commissioner. (Id. at 1-6.) Plaintiff now seeks judicial review of that decision.

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2 “[T]o be eligible for DIB, a claimant must prove continuous disability that began on or

before the date last insured[.]” Hasji v. Kijakazi, No. 21-15319, 2023 WL 6458648, at *1 (9th

Cir. Oct. 4, 2023) (first citing 42 U.S.C. § 423(a)(1)(A), (c)(1); then citing 20 C.F.R. § 404.131;

and then citing Flaten v. Sec’y of Health & Hum. Servs., 44 F.3d 1453, 1459 (9th Cir. 1995)); see

also Sam v. Astrue, 550 F.3d 808, 810 (9th Cir. 2008) (per curiam) (noting that “only disabilities

existing before [the] date last insured establish entitlement to [DIB]” (citing Vincent v. Heckler,

739 F.2d 1393, 1394 (9th Cir. 1984) (per curiam))). As a result, Plaintiff needed to prove

continuous disability that began on before December 31, 2017, his date last insured (“DLI”).

(Tr. 28.)

II. THE SEQUENTIAL PROCESS

A claimant is considered 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 [twelve]

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). Those five

steps are: (1) whether the claimant is engaged in substantial gainful activity; (2) whether the

claimant has a severe impairment; (3) whether the impairment meets or equals a listed

impairment; (4) whether the claimant can return to any past relevant work; and (5) whether the

claimant can perform other work that exists in significant numbers in the national economy. Id.

at 724-25.

The claimant bears the burden of proof for the first four steps. See Bustamante v.

Massanari, 262 F.3d 949, 953-54 (9th Cir. 2001). If the claimant fails to meet the burden at any

of those steps, the claimant is not disabled. See id. at 954. The Commissioner bears the burden of

proof at step five, where the Commissioner must show 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). If the Commissioner fails to meet this burden, the claimant is

disabled. See Bustamante, 262 F.3d at 954.

III. THE ALJ’S DECISION

The ALJ applied the five-step sequential evaluation process to determine if Plaintiff is

disabled. (Tr. 28-39.) At step one, the ALJ concluded that Plaintiff had not engaged in

substantial gainful activity since October 17, 2017. (Id. at 28.) At step two, the ALJ found that

Plaintiff suffers from the following severe impairments: (1) degenerative disc disease,

(2) osteoarthritis, and (3) psoriatic arthritis. (Id.) At step three, the ALJ determined that Plaintiff

did not have an impairment that meets or medically equals a listed impairment. (Id. at 31.)

The ALJ then found that Plaintiff had the residual functional capacity (“RFC”) to

perform the full range of medium work as defined in 20 C.F.R. § 404.1567(c).3 (Id. at 33.) At

step four, the ALJ concluded that Plaintiff was capable of performing his past relevant work as a

quality assurance analyst. (Id. at 38.) Consequently, the ALJ found that Plaintiff was not disabled

at any time from October 17, 2017, his alleged onset date, through December 31, 2017, his date

last insured. (Id. at 39.)

DISCUSSION

Plaintiff raises two primary issues on appeal. First, Plaintiff argues that the ALJ failed to

identify specific, clear, and convincing reasons supported by substantial evidence in the record to

reject Plaintiff’s symptom testimony. (Pl.’s Br. at 2, ECF No. 15.) Second, Plaintiff argues that

the ALJ improperly evaluated the persuasiveness of the medical opinions of Thomas McAndrew,

M.D. (“Dr. McAndrew”), and Matthew Cornia, PA-C (“Cornia”). (Id.)

For the reasons discussed below, the Court finds that the ALJ’s decision is free of legal

error and supported by substantial evidence. The Court therefore affirms the Commissioner’s

decision.

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3 The regulations define “medium work” as lifting no more than fifty pounds at a time

with frequent lifting or carrying of objects weighing up to twenty-five pounds; standing or

walking for a total of approximately six hours in an eight-hour workday; frequent bending and

stooping; and use of hands and arms to grasp, hold, and turn objects. See SSR 83-10, 1983 WL

31251 at *6.

I. PLAINTIFF’S SYMPTOM TESTIMONY

A. Applicable Law

The Ninth Circuit has “established a two-step analysis for determining the extent to

which a claimant’s symptom testimony must be credited[.]” Trevizo v. Berryhill, 871 F.3d 664,

678 (9th Cir. 2017). “First, the ALJ must determine whether the claimant has presented objective

medical evidence of an underlying impairment ‘which could reasonably be expected to produce

the pain or other symptoms alleged.’” Garrison v. Colvin, 759 F.3d 995, 1014 (9th Cir. 2014)

(quoting Lingenfelter v. Astrue, 504 F.3d 1028, 1035-36 (9th Cir. 2007)). Second, “[i]f the

claimant meets the first test and there is no evidence of malingering, the ALJ can only reject the

claimant’s testimony about the severity of the symptoms if she gives specific, clear and

convincing reasons for the rejection.” Ghanim v. Colvin, 763 F.3d 1154, 1163 (9th Cir. 2014)

(citation omitted).

B. Analysis

There is no evidence of malingering here and the ALJ determined that Plaintiff provided

objective medical evidence of underlying impairments which might reasonably produce the

symptoms alleged. (Tr. 36.) As such, the ALJ was required to provide clear and convincing

reasons for discounting Plaintiff’s symptom testimony. See Ghanim, 763 F.3d at 1163. The Court

finds that the ALJ satisfied that standard here.

1. Effective Treatment

Substantial evidence supports the ALJ’s discounting of Plaintiff’s testimony on the

ground that Plaintiff’s symptoms resolved following effective treatment. See generally Ahearn v.

Saul, 988 F.3d 1111, 1115 (9th Cir. 2021) (“[T]he threshold for [substantial] evidentiary

sufficiency is not high. Substantial evidence . . . is more than a mere scintilla. It means—and

means only—such relevant evidence as a reasonable mind might accept as adequate to support a

conclusion.” (quoting Biestek v. Berryhill, 587 U.S. 97, 103 (2019))).

It is well settled that an ALJ may discount a claimant’s testimony based on evidence that

his symptoms improved with treatment or were well controlled with medication. For example, in

Burkett v. Saul, 806 F. App’x 509, 512 (9th Cir. 2020), the Ninth Circuit held that the ALJ

provided clear and convincing reasons for discounting the claimant’s symptom testimony, and in

doing so, noted that the ALJ appropriately found that the claimant’s testimony was inconsistent

with “record evidence that her kidney disease had improved, record evidence that her

hypertension was under control, and record evidence that her depression [was] well controlled

(when on medication regularly).” Id. (simplified); see also Warre v. Comm’r of Soc. Sec. Admin.,

439 F.3d 1001, 1006 (9th Cir. 2006) (explaining that “[i]mpairments that can be controlled

effectively with medication are not disabling for the purpose of determining eligibility for

[disability] benefits”).

Similarly, in Fletcher-Silvas v. Saul, 791 F. App’x 647, 649 (9th Cir. 2019), the Ninth

Circuit held that the ALJ provided clear and convincing reasons for discounting the claimant’s

testimony regarding her limitations. Id. The Ninth Circuit noted that the ALJ appropriately found

that the claimant’s testimony that “her left leg improved only slightly and her right leg did not

really improve following her knee replacement surgeries . . . conflicted with [her] self-reports to

treatment providers and with the objective indicia of improvement in her medical record.” Id.;

see also Darling v. Kijakazi, No. 22-35594, 2023 WL 4103935, at *2 (9th Cir. June 21, 2023)

(holding that the ALJ provided clear and convincing reasons to discount the claimant’s symptom

testimony, including “treatment efficacy[] and longitudinal improvement”); Walker v. Kijakazi,

No. 22-35351, 2023 WL 3017946, at *1 (9th Cir. Apr. 20, 2023) (holding that substantial

evidence supported that the claimant’s “pain improved after treatment and medication”); Torres

v. Saul, 798 F. App’x 979, 981 (9th Cir. 2019) (“The [ALJ] proffered specific, clear, and

convincing reasons for discounting [the claimant’s] pain and limitations testimony because the

record showed that [her] conditions improved with treatment and were less severe than

alleged.”).

Consistent with these authorities, the ALJ appropriately discounted Plaintiff’s symptom

testimony on the ground that his symptoms improved—and even resolved—shortly after surgical

treatment. The ALJ noted that Plaintiff began complaining of exacerbated back pain in October

2017. (Tr. 35.) He was thereafter referred for decompression surgery, but his procedure was

postponed until January 2018—after his DLI—due to ongoing heavy tobacco use. (Id.) The ALJ

pointed out that Plaintiff was discharged in good condition two days after his surgery, and by

five weeks post-surgery, Plaintiff’s leg pain had completely resolved and he was described as

“extremely happy.” (Id., citing id. at 381.) The ALJ further noted that by May 2018, Plaintiff

“ha[d] no symptoms whatsoever” and he “had complete relief of his pain and he feels great.”

(Id., citing id. at 379.)

Substantial evidence supports the ALJ’s evaluation of Plaintiff’s testimony. Of note, the

record reflects that Plaintiff sustained “remarkable” improvement after treatment. (See id. at 373,

381, 383.) For example, at his four-month follow-up medical appointment in May 2018, Plaintiff

had “normal strength, [and] range of motion of hips and knees.” (Id. at 380.) He was able to

ambulate “without any evidence of anomaly whatsoever.” (Id.) Plaintiff was described by

providers as “doing fabulous” and he “couldn’t be happier.” (Id.)

Plaintiff does not challenge the ALJ’s conclusions with respect to the success of his back

surgery. Plaintiff instead focuses on the ALJ’s alleged failure to “adequately consider

[Plaintiff’s] ongoing restrictions to avoid reinjury.” (Pl.’s Br. at 7.) Plaintiff contends that the

restrictions a provider recommended two weeks after his back surgery, including no bending,

twisting, or lifting more than ten pounds, were meant to be lifelong restrictions, rather than

temporary instructions specific to Plaintiff’s period of post-surgery recovery, because there is no

evidence that the provider ever lifted those restrictions. (Id. at 6-7.) Plaintiff argues that if the

ALJ had incorporated those post-surgery restrictions into the RFC, Plaintiff would be considered

per se disabled. (Id. at 7.) The Court disagrees.

To begin, the only evidence in the record that Plaintiff was under any “lifelong” activity

restrictions comes from a single treatment note in January 2022, wherein his provider stated that

“[Plaintiff] was cutting firewood and doing heavy work with his back despite the fact that I

[gave] him some restrictions that were lifelong to avoid as much reinjury issues as possible.” (Id.

at 373.) But that provider does not elaborate on what lifelong restrictions he recommended,4 nor

does the provider articulate any further or future restrictions for Plaintiff. (Id. at 375.)

The record is, at best, ambiguous as to the duration of any restrictions that Plaintiff’s

providers recommended following his back surgery. At the hearing, Plaintiff testified that the

lifelong restrictions were “no more strenuous woodcutting, and no riding in motorboats, and

things like that.” (Id. at 67.) By way of comparison, at his final follow-up appointment in May

2018, four months after his surgery, Plaintiff’s provider simply noted that “[d]o’s and [d]on’ts

were discussed.” (Id. at 380.) This non-specific entry does not support Plaintiff’s argument that

his provider intended any post-surgery restrictions to apply for the rest of his life.

4 Plaintiff’s counsel acknowledged at the hearing that Plaintiff’s medical records do not

include any descriptions of a lifelong restriction. During the administrative hearing, Plaintiff’s

attorney asked for Plaintiff to describe the restrictions because “the doctor says that he had given

you lifelong restrictions, and that isn’t in any of the charts that we have, what those restrictions

are.” (Tr. 67.)

It is also notable that there is no evidence in the record that any other medical provider

recommended or referenced any lifelong restrictions. Plaintiff continued to see medical providers

after his post-surgery follow-up visit in May 2018, and no provider documented any continuing

restrictions, despite Plaintiff’s ongoing participation in strenuous activities such as hunting,

hiking, and wood chopping. For example, Plaintiff visited a provider in November 2018,

complaining of foot pain related to increased activity, including hunting and hiking in the woods,

and the notes of the visit do not reference any restrictions. (Id. at 376.) At a routine appointment

in May 2020, Plaintiff was described as “staying active cutting wood for winter” and he had

already cut “[two] cords” of wood. (Id. at 428.) Notably, Plaintiff did not complain of increased

back pain from these activities, nor did his providers communicate any warnings relating to

restrictions resulting from his back surgery. (Id. at 376-77, 428-30.) In fact, Plaintiff did not

complain of renewed back pain, joint pain, or any other associated symptoms until December 14,

2021, nearly four years after his DLI. (See id. at 405-09.) For these reasons, the ALJ’s

conclusion that a provider’s post-surgery restrictions were not intended to be lifelong restrictions

was reasonable, and the ALJ was not required to include any such restrictions in the RFC

determination. See Bayliss v. Barnhart, 427 F.3d 1211, 1217 (9th Cir. 2005) (noting that an

ALJ’s RFC determination need only include those limitations found credible and supported by

substantial evidence). Accordingly, the Court finds that the ALJ appropriately discounted

Plaintiff’s symptom testimony on the ground that his symptoms improved after surgery and did

not err by failing to include any surgery-related restrictions in Plaintiff’s RFC.

2. Objective Medical Evidence

An ALJ may consider the lack of corroborating objective medical evidence as a “relevant

factor in determining the severity of the claimant’s” alleged symptoms. Rollins v. Massanari,

261 F.3d 853, 857 (9th Cir. 2001). The ALJ may not, however, “discredit the claimant’s

testimony as to subjective symptoms merely because they are unsupported by objective

evidence.” Berry v. Astrue, 622 F.3d 1228, 1234 (9th Cir. 2010) (quoting Lester v. Chater, 81

F.3d 821, 834 (9th Cir. 1995)); see also 20 C.F.R. § 404.1529(c)(2) (noting that the

Commissioner “will not reject your statements about the intensity and persistence of your pain or

other symptoms or about the effect your symptoms have on your ability to work solely because

the available objective medical evidence does not substantiate your statements”). Nevertheless,

an ALJ may discount a claimant’s testimony where it is inconsistent with the objective medical

evidence. See Bray v. Comm’r of Soc. Sec. Admin., 554 F.3d 1219, 1227 (9th Cir. 2009)

(upholding the ALJ’s rejection of [the claimant]’s testimony, in part, because it conflicted with

the objective evidence); 20 C.F.R. § 404.1529(c)(4) (explaining that ALJs “consider whether

there are any inconsistencies in the evidence and the extent to which there are conflicts between

[a claimant’s] statements and the rest of the evidence, including . . . the signs and laboratory

findings, and statements by [] medical sources”).

The ALJ properly relied on objective medical evidence in discounting Plaintiff’s

symptom testimony. To begin, as the ALJ noted, Plaintiff testified that he was unable to work

during the relevant period due to psoriatic arthritis, but the record reflects no ongoing treatment

for psoriatic arthritis during the relevant time period. (Tr. 36, 55.) Although Plaintiff’s history

with psoriatic arthritis was discussed at medical appointments in the context of his medical

history, there is no mention of ongoing treatment or any recommendation for new treatment

during the period in question. (See id. at 444, 569.) Nor is there any discussion of exacerbated

psoriatic arthritis symptoms during the relevant period. Thus, the ALJ did not err in finding

Plaintiff’s testimony that psoriatic arthritis prevented him from working during the relevant

period was inconsistent with the medical evidence of record. See Carmickle v. Comm’r, Soc. Sec.

Admin., 533 F.3d 1155, 1161 (9th Cir. 2008) (noting that contradiction with the medical record is

a valid reason to reject a claimant’s testimony).

Plaintiff argues that the ALJ improperly concluded that his “statements concerning the

intensity, persistence and limiting effects of these symptoms were not entirely consistent with the

medical evidence prior to the date last insured.” (Pl.’s Br. at 5.) Plaintiff asserts that “the

claimant is not limited to medical records existing prior to the date his disability insurance

coverage expired to establish that his disability existed on or before that date.” (Id.) Plaintiff is

correct, but the ALJ did not restrict his evaluation or findings to the pre-DLI time period. In

reviewing the ALJ’s decision, it is clear that the ALJ reviewed the record as a whole, as the

regulations require. (See, e.g., Tr. 36-39, addressing Plaintiff’s medical records from 2017

through early 2022); see also SSR 16-3p, available at 2016 WL 1119029 (“Consistent with our

regulations, we instruct [ALJs] to consider all of the evidence in an individual’s record when

they evaluate the intensity and persistence of symptoms”).

In any event, although the ALJ must consider the entire record, the burden rests with the

claimant to provide sufficient evidence that a disabling condition existed prior to the DLI. See,

e.g., Artis v. Barnhart, 97 F. App’x, 740, 741 (9th Cir. 2004) (upholding the ALJ’s denial of

benefits where Plaintiff did not provide sufficient evidence that a disability existed prior to the

DLI); Tidwell v. Apfel, 161 F.3d 599, 601 (9th Cir. 1998) (upholding the ALJ’s denial of benefits

where the medical evidence did not establish that a disability existed prior to the claimant’s

DLI). Plaintiff has failed to point to sufficient evidence to establish disability prior to his DLI.

Rather, the record reflects that Plaintiff successfully engaged in a variety of physically

demanding pursuits after his back surgery, and sought minimal medical treatment for any of his

asserted disabling conditions until January 2022:

• May 7, 2018: At his final post-surgery follow-up appointment, the provider

describes Plaintiff as having “no symptoms whatsoever” and “complete relief”

from pain. (Tr. 379.)

• November 27, 2018: Plaintiff reports foot pain from increased activity, including

hunting and hiking in the woods. Testing reflected that his pain was consistent

with osteoarthritis, secondary to a joint fusion operation eight years prior. The

provider recommended only conservative treatment, including ice, anti-

inflammatories, and supportive inserts, and noted no other restrictions. (Id. at 376-

77.)

• January 30, 2020: Plaintiff visited Dr. McAndrew for an annual examination. (Id.

at 520-30.) Dr. McAndrew noted he had not seen Plaintiff in the last year and

described Plaintiff’s back surgery as having occurred “several years ago without

recurrence” and his psoriatic arthritis as “without any signs or symptoms.” (Id. at

520, 530.) Dr. McAndrew did not reference any restrictions relating to Plaintiff’s

back, and his objective examination showed Plaintiff had “no myalgias, no joint

stiffness, no joint swelling, no back pain and no arthralgias.” (Id. at 522.)

• February 17, 2020: Plaintiff visited a provider for blood pressure and alcohol use

disorder symptoms. Plaintiff had “no myalgias, no joint stiffness, no joint

swelling, no back pain and no arthralgias.” (Id. at 439.)

• March 5, 2020: Plaintiff visited a provider for medication management, anxiety,

and blood pressure. (Id. at 435.)

• March 8, 2020: Plaintiff called his provider with questions relating to dehydration

and low blood pressure symptoms. (Id. at 434.)

• April 1, 2020: Plaintiff called for medication management follow-up, and reported

feeling better with Lexapro. (Id. at 431.)

• May 5, 2020: Plaintiff reported to Dr. McAndrew that he “has been staying active

cutting wood for the coming winter” and “[h]e already has put up [two] cords.”

(Id. at 428.) No precautions or reminders of post-surgery restrictions were

discussed.

• March 19, 2021: Dr. McAndrew noted he had not seen Plaintiff since May 2020.

(Id. at 424.) Plaintiff did not report any back pain and Dr. McAndrew noted

normal objective findings. (Id. at 426.)

• December 14, 2021: Plaintiff visited a provider for lumbar pain and was referred

for magnetic resonance imaging. (Id. at 405-09.)

• January 25, 2022: Plaintiff reported increased back pain, likely the result of a

mechanical source such a joint dysfunction. Her provider prescribed anti-

inflammatory medication and requested electromyography and nerve conduction

studies. (Id. at 373, 375.)

• March 21, 2022: Plaintiff’s back pain improved with conservative treatment. He

reported it “still hurts but not near as bad as it used to.” (Id. at 563.) Plaintiff said

he was “pretty happy with that.” (Id.)

As the record demonstrates, the ALJ’s conclusion that Plaintiff’s symptom testimony was

inconsistent with the medical evidence is a reasonable interpretation of the record. Although

Plaintiff offers an alternative interpretation, it is ultimately the ALJ’s responsibility to resolve

any ambiguities in the medical evidence. See Tommasetti v. Astrue, 533 F.3d 1035, 1041-42 (9th

Cir. 2008) (stating that an ALJ “is the final with respect to resolving ambiguities in the medical

evidence.”).

3. Conclusion

For all of these reasons, the Court concludes that the ALJ provided clear and convincing

reasons for discounting Plaintiff’s symptom testimony, and did not commit harmful error.

II. MEDICAL OPINION EVIDENCE

Plaintiff argues that the ALJ erred in evaluating the persuasiveness of the medical

opinions of Dr. McAndrew and Cornia. (Pl.’s Br. at 8-12.)

A. Applicable Law

“In January 2017, the Social Security Administration issued revised regulations for

evaluating medical opinions relating to claims filed on or after March 27, 2017.”5 Cross v.

O’Malley, 89 F.4th 1211, 1214 (9th Cir. 2024) (citation omitted). The revised “regulations

provide that ALJs will no longer ‘defer or give any specific evidentiary weight’ to any medical

opinion.”6 Id. (quoting 20 C.F.R. § 416.920c(a)). Instead, “ALJ[s] must assess the

persuasiveness of each medical opinion after considering specified factors.” Stiffler v. O’Malley,

5 The parties agree the revised regulations apply because Plaintiff filed his application

after March 27, 2017. (See Pl.’s Br. at 8; Def.’s Br. at 6-7, ECF No. 17.)

6 In Cross, the Ninth Circuit held that the revised regulations are valid under both the

Social Security Act and Administrative Procedures Act. 89 F.4th at 1216-17. Recently, “[t]he

Supreme Court . . . overruled Chevron, U.S.A., Inc. v. Natural Resources Defense Council, Inc.,

467 U.S. 837 (1984), which ‘required courts to defer to permissible agency interpretations of the

statutes those agencies administer—even when a reviewing court reads the statute differently.’”

Williams v. O’Malley, No. 23-35358, 2024 WL 3519774, at *1 n.1 (9th Cir. July 24, 2024)

(quoting Loper Bright Enters. v. Raimondo, 144 S. Ct. 2244, 2254 (2024)). In Cross, the Ninth

Circuit “held that the [Social Security] Act ‘plainly encompasse[d] the Commissioner’s authority

to adopt regulations to govern the weighing of medical evidence,’ without deferring to the

agency’s interpretation of the statute.” Id. (quoting Cross, 89 F.4th at 1215). Consequently, the

Ninth Circuit has found that the Supreme Court’s decision in “Loper does not undercut Cross.”

Id.

102 F.4th 1102, 1106 (9th Cir. 2024) (citing Woods v. Kijakazi, 32 F.4th 785, 791-92 (9th Cir.

2022) and 20 C.F.R. §§ 404.1520c(a)-(c), 416.920c(a)-(b))).

Specifically, the revised “regulations require an ALJ to discuss the supportability and

consistency of medical evidence—the factors the agency has historically found to be the most

important in evaluating medical opinions—while allowing for discussion of other factors listed

in paragraphs (c)(3) through (c)(5), as appropriate.” Cross, 89 F.4th at 1215 (citing 20 C.F.R.

§ 416.920c(a)); see also Woods, 32 F.4th at 791 (“‘The most important factors’ that the agency

considers when evaluating the persuasiveness of medical opinions are ‘supportability’ and

‘consistency.’” (quoting 20 C.F.R. § 404.1520c(a))). “Supportability focuses on whether ‘a

medical source supports a medical opinion by explaining the relevant objective medical

evidence.’” Stiffler, 102 F.4th at 1106 (quoting Woods, 32 F.4th at 791-92); see also Kitchen v.

Kijakazi, 82 F.4th 732, 740 (9th Cir. 2023) (“Supportability concerns how ‘a medical source

supports a medical opinion’ with relevant evidence[.]” (quoting Woods, 32 F.4th at 791-92)).

“Consistency means the extent to which a medical opinion is consistent with the evidence from

other medical sources and nonmedical sources[.]” Stiffler, 102 F.4th at 1106 (quoting Woods, 32

F.4th at 792).

In addition to supportability and consistency, “[a]n ALJ may discuss other factors [listed

in paragraphs (c)(3) through (c)(5)], such as the medical source’s ‘relationship with the claimant’

or ‘specialization,’ but generally has no obligation to do so.” Cross, 89 F.4th at 1214 (citing 20

C.F.R. § 416.920c(b)(2)). If, however, an “ALJ finds two or more contradictory medical

opinions ‘both equally well-supported . . . and consistent with the record[,]’ . . . the regulations

mandate discussion of these other factors.” Id. at 1214-15 (quoting 20 C.F.R. § 416.920c(b)(3),

(c)(3)-(5)).

A district court reviews the ALJ’s evaluation of a medical opinion for substantial

evidence. See Woods, 32 F.4th at 787 (“Now, [under the new regulations,] an ALJ’s decision,

including the decision to discredit any medical opinion, must simply be supported by substantial

evidence.”); id. at 792 (“Even under the new regulations, an ALJ cannot reject an examining or

treating doctor’s opinion as unsupported or inconsistent without providing an explanation

supported by substantial evidence.”); Metcalf v. Kijakazi, No. 22-35201, 2022 WL 17592194, at

*1 (9th Cir. Dec. 13, 2022) (observing that “under the revised regulations . . . , the ALJ’s

evaluation of a medical opinion is reviewed for substantial evidence” (citing Woods, 32 F.4th at

789)).

B. Analysis

Plaintiff fails to demonstrate that the ALJ committed harmful error in discounting the

medical opinions of Dr. McAndrew and Cornia.

1. Thomas McAndrew, M.D.

a. Dr. McAndrew’s Opinion

On February 11, 2022, Dr. McAndrew completed a questionnaire he received from

Plaintiff’s counsel regarding Plaintiff’s treatment history, diagnoses, and work-related functional

limitations. (Tr. 556-61.) Dr. McAndrew reported he had treated Plaintiff for greater than ten

years for conditions including psoriatic arthropathy, chronic lumbar pain with degenerative joint

disease, and “post traumatic stress disorder/generalized anxiety disorder.” (Id. at 557.)

Dr. McAndrew listed Plaintiff’s symptoms simply as “back pain, weakness, fatigue.” (Id. at

558.) In response to a request to “describe the patient’s signs (relevant clinical findings, test

results, etc.),” Dr. McAndrew replied that “last lumbar MRI in 2017 showing multi level

[degenerative joint disorder] [and] neuroforaminal stenosis – underwent lumbar dis[c]ectomy in

2018.” (Id.)

With respect to functional limitations, Dr. McAndrew opined that Plaintiff would be

“unable to sit/stand/walk greater than 60 minutes.” (Id.) He could walk four city blocks without

rest or significant pain, and could sit, stand/walk for only two hours in an eight-hour workday.

(Id. at 559.) Dr. McAndrew further opined that Plaintiff would require an unscheduled fifteen-

minute break every one-to-two hours, could only occasionally lift ten pounds or less, and never

lift twenty pounds or more. (Id.) Dr. McAndrew indicated Plaintiff had no limitations in doing

repetitive handling or fingering manipulations, but then opined Plaintiff was limited to using his

hands and arms only ten percent in a given workday. (Id. at 560.) Dr. McAndrew stated that

Plaintiff would periodically need to elevate his legs in a physical eight-hour period. (Id.)

Dr. McAndrew concluded that Plaintiff would be absent from work due to his impairments more

than four days per month and stated that all of Plaintiff’s limitations identified in his opinion had

been present since he began treating Plaintiff. (Id. at 561.)

b. The ALJ’s Decision

The ALJ found Dr. McAndrew’s opinion not persuasive, in part because none of the

limitations that Dr. McAndrew identified in his opinion were supported by the record. (Id. at 37.)

The ALJ further observed that the limitations identified in Dr. McAndrew’s opinion were

inconsistent with his own treatment records, which “document relatively normal physical exam

findings, particularly leading up to and proceeding the period at issue.” (Id. at 37, citing id. at

379, 381, 383, 441-64.) By way of example, the ALJ cited Plaintiff’s complete resolution of his

back pain and radicular symptoms following his lumbar surgery. (Id., citing id. at 379, 381, 383.)

The ALJ further noted that Plaintiff did not experience an exacerbation of his low back pain

symptoms until January 2022,7 following a period in which he performed heavy work and

chopped firewood. (Id., citing id. at 373.) In summary, the ALJ concluded that Dr. McAndrew’s

“exaggerated limitations are unsupported by the evidence as a whole” and the evidence did not

support limiting Plaintiff “beyond the full range of medium work during the period at issue.”

(Id.)

c. Disposition

The Court concludes that substantial evidence supports the ALJ’s evaluation of Dr.

McAndrew’s opinion.

In reviewing the record, the Court agrees that Dr. McAndrew’s own records do not

include the limitations set forth in his opinion. For example, none of Dr. McAndrew’s (or any

other provider’s) notes contain any reference to Plaintiff needing to elevate his legs periodically,

nor are there any recommendations from Dr. McAndrew that Plaintiff limit the amount of weight

he can lift. (See, e.g., id. at 400, 563, 585, 592, 627, 633, 643, 647, 650, 658.) Additionally, as

the ALJ noted, Dr. McAndrew’s opinion is inconsistent with evidence reflecting that Plaintiff

had normal physical examination results and was physically active after his surgery. (See, e.g.,

id. at 379, 383, 387, 441-64.) Therefore, the Court finds that the ALJ’s conclusions were

reasonable and supported by substantial evidence.

Plaintiff does not challenge the ALJ’s supportability and consistency analysis of Dr.

McAndrew’s opinion, but instead reasserts his argument that the ALJ failed to “adequately

consider the lifelong restrictions placed on him to avoid reinjury to his back.” (Pl.’s Br. at 10.)

7 The ALJ incorrectly refers to the date of the cited record as January 2021, but it is dated

January 2022. (Tr. 373.) The Court assumes the discrepancy to be a harmless scrivener’s error,

and uses the correct date contained within the record. (See id.)

For the reasons discussed above, the record does not support any such lifelong restrictions.

Accordingly, the Court finds that the ALJ did not err in evaluating Dr. McAndrew’s opinion.

2. Matthew Cornia, PA-C

a. Cornia’s Opinions

Plaintiff had an appointment with Cornia in January 2018 for pre- and post-operative

evaluations in connection with his back surgery. (Tr. 341-42, 383, 385-86.) Plaintiff was

discharged from the hospital on January 10, 2018 following his back surgery. (Id. at 342.) Cornia

provided hospital discharge aftercare instructions, including that Plaintiff should do “no bending,

twisting, lifting more than [ten to twenty] pounds.” (Id.) On January 19, 2018, Plaintiff returned

for his two-week post-surgery follow-up visit, and Cornia again advised that Plaintiff should

“continue to follow his back precautions,” including “no bending, twisting, [or] lifting more than

[ten] pounds.” (Id. at 383.) Cornia also advised that Plaintiff could walk with the aid of an

ambulatory device. (Id.)

b. The ALJ’s Decision

The ALJ found Cornia’s opinions to be unpersuasive. (Id. at 37.) The ALJ first noted that

the restrictions assessed by Cornia were “placed after Plaintiff’s date last insured,” and therefore

did not apply to the period of disability at issue. (Id.) The ALJ further stated that Cornia’s

opinion proffered restrictions that were “temporary,” and placed in the context of post-operative

instructions intended for the first few weeks after Plaintiff’s lumbar surgery. (Id.) The ALJ cited

Plaintiff’s statements to providers that his symptoms had completely resolved within four months

of his surgery, and noted Plaintiff resumed strenuous activities such as hunting and hiking only a

few months later. (Id., citing id. at 376, 379.) Finally, the ALJ noted that the restrictions in

Cornia’s opinion were inconsistent with Plaintiff’s post-surgery functioning. (Id.)

///

c. Disposition

The Court concludes that substantial evidence supports the ALJ’s evaluation of Cornia’s

opinion. The ALJ adequately supported his conclusion that Cornia’s recommended restrictions

were related to a temporary post-surgery period, and the restrictions were inconsistent with the

record reflecting that Plaintiff's symptoms were resolved by his four-month post-surgery

appointment. Plaintiff relies again on his argument that Cornia’s post-surgery precautions were

not temporary because the record does not document that Cornia ever lifted the restrictions. (Pl.’s

Br. at 11.) However, as discussed, the record before the Court does not support Plaintiff's

interpretation of the evidence. For these reasons, the Court finds that the ALJ did not err in

discounting Cornia’s opinion. See Vazquez v. Kijakazi, No. 22-35642, 2023 WL 5453198, at *1

(9th Cir. Aug. 24, 2023) (“[T]he ALJ’s alternative interpretation . . . is at least equally rational,

and the reasoning is legally sufficient.”); Ford v. Saul, 950 F.3d 1141, 1154 (th Cir. 2020) (If

the evidence is susceptible to more than one rational interpretation, it is the ALJ’s conclusion

that must be upheld.”) (simplified).

CONCLUSION

For the reasons stated, the Court AFFIRMS the Commissioner’s decision because it is

free of harmful legal error and supported by substantial evidence.

IT IS SO ORDERED.

DATED this 27th day of March, 2025. "Ki

Si MaeF eee T

HON. STACIE F. BECKERMAN

United States Magistrate Judge

PAGE 21 —- OPINION AND ORDER