Dawisha-Sexton v. Commissioner Social Security Administration

IN THE UNITED STATES DISTRICT COURT

FOR THE DISTRICT OF OREGON

PENDLETON DIVISION

JACOB D.,1 Case No. 6:24-cv-01191-HL

Plaintiff, OPINION AND ORDER

v.

COMMISSIONER, SOCIAL

SECURITY ADMINISTRATION,

Defendant.

_________________________________________

HALLMAN, United States Magistrate Judge:

Plaintiff Jacob D. brings this action under the Social Security Act (the “Act”), 42 U.S.C.

§ 405(g), to obtain judicial review of a final decision of the Commissioner of Social Security

(“Commissioner”). The Commissioner denied plaintiff’s applications for Disability Insurance

Benefits (“DIB”) and Social Security Income (“SSI”) under Titles II and XVI of the Act. 42

U.S.C. § 401 et seq. For the following reasons, the decision of the Commissioner is AFFIRMED.

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

for non-governmental parties and their immediate family members.

STANDARD OF REVIEW

42 U.S.C. § 405(g) provides for judicial review of the Social Security Administration’s

disability determinations: “The court shall have power to enter . . . a judgment affirming,

modifying, or reversing the decision of the Commissioner of Social Security, with or without

remanding the cause for a rehearing.” The court must affirm the Commissioner’s decision if it is

based on proper legal standards and the findings are supported by substantial evidence in the

record. Hammock v. Bowen, 879 F.2d 498, 501 (9th Cir. 1989). Substantial evidence is “more

than a mere scintilla. It means such relevant evidence as a reasonable mind might accept as

adequate to support a conclusion.” Richardson v. Perales, 402 U.S. 389, 401 (1971) (quotation

omitted). The court must weigh “both the evidence that supports and detracts from the

[Commissioner’s] conclusion.” Martinez v. Heckler, 807 F.2d 771, 772 (9th Cir. 1986). “Where

the evidence as a whole can support either a grant or a denial, [the court] may not substitute [its]

judgment for the ALJ’s.” Massachi v. Astrue, 486 F.3d 1149, 1152 (9th Cir. 2007) (citation

omitted); see also Burch v. Barnhart, 400 F.3d 676, 679 (9th Cir. 2005) (holding that the court

“must uphold the ALJ’s decision where the evidence is susceptible to more than one rational

interpretation”). “[A] reviewing court must consider the entire record as a whole and may not

affirm simply by isolating a specific quantum of supporting evidence.” Orn v. Astrue, 495 F.3d

625, 630 (9th Cir. 2007) (quotation omitted).

BACKGROUND

I. Plaintiff’s Application

Plaintiff alleges disability based on depressive disorder, possible autism, post-traumatic

stress disorder (“PTSD”), attention-deficit hyperactivity disorder, dissociative identity disorder,

and nonverbal sometimes. Tr. 309.2 At the time of plaintiff’s alleged onset date, he was 23 years

old. Tr. 24.3 He has an eleventh-grade education and has past relevant work experience as a

cashier, commercial cleaner, survey worker, and reservation clerk. Tr. 24, 310.

Plaintiff protectively applied for DIB and SSI in November 2020. Tr. 316-18. His

applications were denied initially on August 2, 2021, and on reconsideration on June 1, 2022. Tr.

64-65, 75-76, 125-26, 149-50. Plaintiff subsequently requested a hearing, which was held on

August 18, 2023, before Administrative Law Judge (“ALJ”) Katherine Weatherly. Tr. 32.

Plaintiff appeared and testified at the hearing, represented by his counsel Mark Manning. Tr. 34.

A vocational expert (“VE”), Michelle Bishop, also testified. Tr. Id. On October 19, 2023, the

ALJ issued a decision denying plaintiff’s claims. Tr. 32. Plaintiff requested Appeals Council

review, which was denied on June May 23, 2024. Tr. 1-3. Plaintiff then sought review before this

Court.4

II. Sequential Disability Process

The initial burden of proof rests upon the claimant to establish disability. Howard v.

Heckler, 782 F.2d 1484, 1486 (9th Cir. 1986). To meet this burden, the claimant must

demonstrate an “inability to engage in any substantial gainful activity by reason of any medically

determinable physical or mental impairment which can be expected . . . to last for a continuous

period of not less than 12 months.” 42 U.S.C. § 423(d)(1)(A).

2 Citations to “Tr.” are to the Administrative Record. (ECF 8).

3 Plaintiff initially identified January 1st, 2008, as the alleged onset date but later amended the

alleged onset of disability to January 1, 2019. Tr. 289.

4 The parties have consented to the jurisdiction of a Magistrate Judge pursuant to 28 U.S.C. §

636. (ECF 5).

The Commissioner has established a five-step process for determining whether a person

is disabled. Bowen v. Yuckert, 482 U.S. 137, 140 (1987); 20 C.F.R. §§ 404.1520, 416.920. At

step one, the Commissioner determines whether a claimant is engaged in “substantial gainful

activity”; if so, the claimant is not disabled. Yuckert, 482 U.S. at 140; 20 C.F.R. §§ 404.1520(b),

416.920(b).

At step two, the Commissioner determines whether the claimant has a “medically severe

impairment or combination of impairments.” Yuckert, 482 U.S. at 140-41; 20 C.F.R. §§

404.1520(c), 416.920(c). A severe impairment is one “which significantly limits [the claimant’s]

physical or mental ability to do basic work activities[.]” 20 C.F.R. §§ 404.1520(c) & 416.920(c).

If not, the claimant is not disabled. Yuckert, 482 U.S. at 141.

At step three, the Commissioner determines whether the impairments meet or equal “one

of a number of listed impairments that the [Commissioner] acknowledges are so severe as to

preclude substantial gainful activity.” Id.; 20 C.F.R. §§ 404.1520(d), 416.920(d). If so, the

claimant is conclusively presumed disabled; if not, the analysis proceeds. Yuckert, 482 U.S. at

141. At this point, the Commissioner must evaluate medical and other relevant evidence to

determine the claimant’s “residual functional capacity” (“RFC”), an assessment of work-related

activities the claimant may still perform on a regular and continuing basis, despite any

limitations his impairments impose. 20 C.F.R. §§ 404.1520(e), 404.1545(b)-(c), 416.920(e),

416.945(b)-(c).

At step four, the Commissioner determines whether the claimant can perform “past

relevant work.” Yuckert, 482 U.S. at 141; 20 C.F.R. §§ 404.1520(e), 416.920(e). If the claimant

can work, he is not disabled; if he cannot perform past relevant work, the burden shifts to the

Commissioner. Yuckert, 482 U.S. at 146 n. 5.

Finally, at step five, the Commissioner must establish that the claimant can perform other

work that exists in significant numbers in the national economy. Id. at 142; 20 C.F.R. §§

404.1520(e) & (f), 416.920(e) & (f). If the Commissioner meets this burden, the claimant is not

disabled. 20 C.F.R. §§ 404.1566, 416.966.

III. The ALJ’s Decision

At step one, the ALJ determined plaintiff had not engaged in substantial gainful activity

since his alleged onset date of January 1, 2019. Tr. 19.

At step two, the ALJ determined plaintiff has the following severe impairments: “autism

spectrum disorder (without intellectual or language impairment); PTSD; bipolar II disorder;

borderline personality disorder; and rule out dissociative disorder.” Tr. 19.

At step three, the ALJ determined plaintiff’s impairments did not meet or medically equal

the severity of a listed impairment. Tr. 20. The ALJ then resolved that plaintiff had the residual

function capacity (“RFC”) to:

perform a full range of work at all exertional levels but with the following non-

exertional limitations: he can persist at simple, routine, repetitive tasks involving

simple work-related decision and changes. He cannot tolerate fast-paced production

work. He can tolerate occasional interaction with co-workers and supervisors. He

cannot tolerate interaction with the public.

Tr. 21

At step four, the ALJ found plaintiff could not perform his past relevant work. Tr. 24.

But at step five—considering plaintiff’s age, education, work experience, and RFC—the

ALJ found a significant number of jobs existed in the national economy that plaintiff could

perform, including work as a routing clerk, marker, and waxer cleaner. Tr. 24-25. Thus, the ALJ

concluded that plaintiff is not disabled. Tr. 25-26.

DISCUSSION

Plaintiff argues the ALJ committed three harmful errors. Pl. Br. at 2. He contends the

ALJ erred by (1) discounting his subjective symptom testimony without a clear and convincing

reason for doing so, (2) rejecting third-party witness testimony without a germane reason, and (3)

improperly evaluating the medical opinions of Walter Rosenthal, QMHP, and Scott Alvord,

PsyD. Id. For the following reasons, the Court finds the ALJ did not err, and affirms.

I. Symptom Testimony

Plaintiff asserts the ALJ improperly rejected his subjective symptom testimony. Pl. Br. at

11-16. This Court disagrees.

A. Legal Standards

The ALJ is responsible for evaluating symptom testimony. SSR 16-3p, 2017 WL

5180304, at *1 (Oct. 25, 2017). There is a two-step process for evaluating a claimant’s testimony

about the severity and limiting effect of his symptoms. Vasquez v. Astrue, 572 F.3d 586, 591 (9th

Cir. 2009). First, the claimant must produce objective medical evidence of one or more

impairments that could reasonably be expected to produce some degree of symptoms.

Lingenfelter v. Astrue, 504 F.3d 1028, 1036 (9th Cir. 2007). The claimant need not show the

impairment could reasonably be expected to cause the severity of the symptoms, but only show it

could reasonably have caused some degree of the symptoms. Id.

Second, the ALJ must assess the claimant’s testimony regarding the severity of the

symptoms. Id. The ALJ can reject the claimant’s testimony “only by offering specific, clear and

convincing reasons for doing so.” Id. Thus, the ALJ must specifically identify the testimony they

discredit and explain what evidence undermines the testimony. Holohan v. Massanari, 246 F.3d

1195, 1208 (9th Cir. 2001). In other words, the “clear and convincing” standard requires an ALJ

to “show [their] work.” Smartt v. Kijakazi, 53 F.4th 489, 499 (9th Cir. 2022).

General findings are insufficient to support an adverse determination; the ALJ must rely

on substantial evidence. Holohan, 246 F.3d at 1208. To discredit a plaintiff’s testimony

regarding the degree of impairment, the ALJ must make a “determination with findings

sufficiently specific to permit the court to conclude that the ALJ did not arbitrarily discredit

claimant’s testimony.” Thomas v. Barnhart, 278 F.3d 947, 958 (9th Cir. 2002). The question is

not whether ALJ’s rationale convinces the court, but whether their rationale “is clear enough that

it has the power to convince.” Smartt, 53 F.4th at 499.

B. Plaintiff’s Testimony

One of plaintiff’s claimed limitations is dissociative identity disorder. Tr. 309.5 At the

administrative hearing, plaintiff testified one of his alters is non-verbal, meaning when this alter

is active, plaintiff is non-verbal. Tr. 39.

Plaintiff testified he worked part-time at a call center in late 2019 while taking online

courses to try to complete his GED. Tr. 38-40. At the call center, he worked four-hour shifts

three or four times a week until he quit “because the stress of the job was too much.” Tr. 39.

Regarding his non-verbal alter, plaintiff explained he would not come into work when non-

verbal, or if he did come in, he “would use [his] phone to text – like show texts that [he] wasn’t

5 “Dissociative identity disorder (DID) . . . is a mental health condition where you have

two or more separate identities . . . People with dissociative identity disorder may

experience several different personalities, usually referred to as alters.” Cleveland Clinic,

Dissociative Identity Disorder (Multiple Personality Disorder), Cleveland Clinic, (June

26, 2025, 12:36 PM), https://my.clevelandclinic.org/health/diseases/9792-dissociative-

identity-disorder-multiple-personality-disorder.

able to communicate in order to let them know that [he] wouldn’t be there.” Tr. 40. Plaintiff then

described his earlier job at WinCo where he worked as a cashier and in maintenance from

November 2015 to December 2017. Tr. 40, 298. When non-verbal at WinCo, plaintiff would

sometimes put up a sign saying so. Tr. 40. Plaintiff reported he has bad depression at times and

attends online therapy either once a week, once every other week, or on bad occasions—such as

preparing for the hearing—twice a week. Tr. 44.

Plaintiff testified he drives, lives with a partner, and is ambidextrous. Tr. 37-38. He

reported he rarely goes places with his partners, goes shopping maybe once a month, and will

meet with friends one-to-three times a month, but will sometimes cancel a day or two in advance.

Tr. 42. Plaintiff testified he spends his days in his living room either on his phone, PC, or

PlayStation. Id. He explained: “I’m usually either gaming or maybe reading something if I have

the capacity for it, but a lot of the time, I end up not being able to read.” Id. On an average day,

plaintiff stated he spends between an hour or up to eight hours of time gaming. Tr. 42-43.

Plaintiff answered “No” when asked by the ALJ if these games are multiplayer games. Tr. 43.

Plaintiff testified his mutism does not occur as frequently, but he will still have occasions of non-

verbal mutism that may last a week or, on one occasion, up to a month. Tr. 46.

In plaintiff’s function report, he stated he was non-verbal and could therefore not work

any jobs requiring talking. Tr. 346. He continued to state he cannot focus enough for time

management, suffers from insomnia, and his lack of sleep combined with his depression keeps

him fatigued and tired all day. Tr. 346-47.

C. Analysis

To reject a plaintiff’s subjective symptom testimony based on objective evidence, an ALJ

must “state which . . . testimony is not credible and what evidence suggests the complaints are

not credible.” Dodrill v. Shalala, 12 F.3d 915, 918 (9th Cir. 1993). Here, the ALJ noted generally

“the claimant’s medically determinable impairments could reasonably be expected to cause the

alleged symptoms; however, the claimant’s statements concerning the intensity, persistence and

limiting effects of these symptoms are not entirely consistent with the medical evidence and

other evidence in the record.” Tr. 22.

Plaintiff first argues the ALJ failed to identify what testimony was inconsistent and what

evidence undermined the testimony. Pl. Br. at 13. This Court disagrees. The ALJ identified how

plaintiff’s ability “to provide extensive handwritten responses to agency questionnaires – to the

point he required an extra page for his elaborations” undermines plaintiff’s testimony of “poor

focus and chronic fatigue.” Tr. 22, 346-54. The ALJ also identified plaintiff’s testimony relating

to his “non-verbal episodes” as inconsistent with plaintiff working “for data research companies

conducting telephone surveys over multiple years.” Tr. 22, 298. Thus, the ALJ reasonably

explained how evidence in the record was inconsistent with Plaintiff’s asserted limitations.

Molina v. Astrue, 674 F.3d 1104, 1112 (9th Cir. 2012) (finding an ALJ may consider

inconsistencies between plaintiff’s testimony and his conduct).

Plaintiff next argues the ALJ improperly rejected plaintiff’s symptom testimony by

discounting his testimony due to a lack of supporting objective medical evidence. Pl. Br. at 14

(citing Berry v. Astrue, 622 F.3d 1228, 1234 (9th Cir. 2010) and Laborin v. Berryhill, 867 F.3d

1151, 1153-54 (9th Cir. 2017)). Plaintiff’s argument is unavailing because the ALJ did not

discount plaintiff’s subjective symptom testimony due to a lack of supporting medical evidence,

but rather due to contradictory medical evidence undermining plaintiff’s testimony. Tr. 22.

The most important factor in evaluating symptom severity is whether the alleged

symptoms are substantiated by the objective medical evidence that is, the signs and clinical and

laboratory findings. 20 C.F.R. §§ 404.1529(c)(2), 416.929(c)(2); SSR 16-3p, 2017 WL

5180304, at *5. In determining whether the alleged symptoms are substantiated, the ALJ will

consider any inconsistencies between plaintiff’s testimony and the rest of the evidence, including

objective medical evidence. 20 C.F.R. §§ 404.1529(c)(4), 416.929(c)(4); see Bray v. Comm’r of

Soc. Sec. Admin., 554 F.3d 1219, 1227 (9th Cir. 2009) (holding inconsistency can be based on

objective medical evidence).

The ALJ cited to inconsistencies between plaintiff’s testimony and plaintiff’s medical

record, such as how despite plaintiff’s complaints of fatigue, depression, and anxiety, plaintiff

“exhibited no signs of depression or anxiety on exam,” nor did he appear socially withdrawn. Tr.

22, 523-24. To the contrary, plaintiff’s “cognition, memory, mood, affect, and speech were all

reportedly ‘normal.’” Id. The ALJ also cited two other office visits in early 2019—around the

time plaintiff alleges his symptoms became disabling—in which plaintiff’s providers reported

“similarly benign findings.” Tr. 22, 533, 542. The ALJ connected this evidence to her assessment

of plaintiff’s testimony by concluding: “[s]uch clinical findings are not indicative of a

debilitating psychological condition.” Tr. 22. The ALJ’s citation to inconsistencies between

plaintiff’s testimony and plaintiff’s medical record is “sufficiently specific to permit the court to

conclude that the ALJ did not arbitrarily discredit claimant’s testimony.” Thomas, 278 F.3d at

958 (9th Cir. 2002).

In sum, the ALJ provided two clear and convincing reasons, supported by substantial

evidence, for discounting plaintiff’s subjective symptom testimony. This is more than sufficient

to affirm her decision on this issue. See Sims v. Berryhill, 704 F. App'x 703, 704 (9th Cir.

2017) (affirming the ALJ's opinion discounting the claimant’s testimony because the ALJ

“provided at least one clear and convincing reason supported by substantial evidence for

rejecting [the] testimony as not credible”).

II. Lay Witness Testimony

Plaintiff asserts the ALJ improperly rejected lay witness testimony—a report from

plaintiff’s case manager, Bridget Jenkins, CADC, QMHA—without providing germane reasons

for doing so. Pl. Br. at 16-17. This Court disagrees.

A. Legal standards

“Lay testimony as to a claimant’s symptoms is competent evidence that the Secretary

must take into account.” Nguyen v. Chater, 100 F.3d 1462, 1467 (9th Cir. 1996) (citation

omitted); 20 C.F.R. §§ 404.1529(c)(1), 416.929(c)(1) (“In evaluating the intensity and

persistence of your symptoms, we consider all of the available evidence from your medical

sources and nonmedical sources about how your symptoms affect you.”). Under the 2017

regulations, the ALJ is not “required to articulate how [they] considered evidence from

nonmedical sources” using the same criteria required for the evaluation of medical sources. 20

C.F.R. §§ 404.1520c(d), 416.920c(d).

The ALJ must give reasons “germane to the witness” when discounting the testimony of

lay witnesses. Valentine v. Comm’r, Soc. Sec. Admin., 574 F.3d 685, 694 (9th Cir. 2009).6 But

6 Citing the revised regulations for medical source opinions and the Ninth Circuit’s unpublished

opinion in Fryer v. Kijakazi, No. 21-36004, 2022 WL 17958630, at *3 n.1 (9th Cir. Dec. 27,

2022), the Commissioner argues the ALJ is no longer required to provide “germane reasons” for

discounting lay witness testimony. Def. Br. 12-13. The Ninth Circuit, in a recent unpublished

opinion, noted it remains “an open question whether the new regulations affect the longstanding

requirement in the Ninth Circuit that an ALJ must give germane reasons for rejecting lay witness

testimony.” Jarrett v. O’Malley, No. 23-3565, 2024 WL 4707890, at *3 (9th Cir. Nov. 7, 2024).

Absent further guidance from the Ninth Circuit, this Court disagrees that the new regulations

provide a basis to reject the Ninth Circuit’s longstanding precedent concerning “germane

reasons.” See Donna B.S. v. O’Malley, No. 6:22-CV-1571-SI, 2024 WL 3534431, at *7 (D. Or.

July 25, 2024) (so holding).

the ALJ is not required “to discuss every witness’s testimony on an individualized, witness-by-

witness basis.” Molina, 674 F.3d at 1114, superseded on other grounds by 20 C.F.R. §

404.1502(a). If the ALJ gives valid germane reasons for rejecting testimony from one witness,

the ALJ may refer only to those reasons when rejecting similar testimony by a different witness.

Id. Additionally, when the ALJ provides clear and convincing reasons for rejecting plaintiff’s

subjective complaints, and the lay witness’ testimony is similar to plaintiff’s complaints, “it

follows that the ALJ also gave germane reasons for rejecting [the lay witness’] testimony.”

Valentine, 574 F.3d at 694.

B. Analysis

Ms. Jenkins’ testimony in this case mirrored plaintiff’s testimony about his symptoms

likely because, in her own words, Ms. Jenkins “can only report what he has claimed to me.” Tr.

367. Ms. Jenkins described mental and physical health-related limitations that tracked plaintiff’s

own allegations. Compare Tr. 37-50 (plaintiff’s testimony) with Tr. 360-67 (Ms. Jenkins’

testimony). Therefore, because the ALJ noted how Ms. Jenkins’ testimony “generally relies on

the claimant’s subjective complaints,” and the ALJ provided clear and convincing reasons to

discount plaintiff’s subjective complaints, the ALJ gave germane reasons for discounting Ms.

Jenkins’ testimony. Tr. 24. Thus, the ALJ’s assessment of Ms. Jenkins was reasonable, based on

the proper legal standards, and supported by substantial evidence.

III. Medical Opinion Evidence

Finally, plaintiff argues the ALJ did not properly consider Scott Alvord’s, PsyD, and

Walter Rosenthal’s, QMHP, medical opinions. Pl. Br., at 3-11. This Court disagrees.

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A. Legal standards

Where, as here, the plaintiff’s application is filed on or after March 27, 2017, the ALJ is

no longer tasked with “weighing” medical opinions, but rather must determine which are most

“persuasive.” 20 C.F.R. §§404.1520c(a)-(b); 416.920c(a)-(b). Under the new regulations, “the

former hierarchy of medical opinions – in which we assign presumptive weight based on the

extent of the doctor’s relationship – no longer applies.” Woods v. Kijakazi, 32 F.4th 785, 787

(9th Cir. 2022). An ALJ’s “decision to discredit any medical opinion, must simply be supported

by substantial evidence.” Id. “The most important factors that the agency considers when

evaluating the persuasiveness of medical opinions are supportability and consistency.” Id. at 791

(emphasis added) (internal quotations omitted); 20 C.F.R. § 404.1520c(a). However, “the extent

of the claimant’s relationship with the medical provider – what we will refer to as ‘relationship

factors’ – remains relevant under the new regulations.” Id. at 790.

Supportability means the extent to which a medical source supports the medical opinion

by explaining the “relevant . . . objective medical evidence.” Woods 32 F.4th at 791-92 (citing 20

C.F.R. § 404.1520c(c)(1)). Consistency means the extent to which a medical opinion is

“consistent . . . with the evidence from other medical sources and nonmedical sources in the

claim.” Id. (citing 20 C.F.R. § 404.1520c(c)(2)). In evaluating the “supportability” and

“consistency” of a medical opinion, the ALJ is not required to articulate how each individual

medical opinion was considered. For example, where a single medical source provides more than

one medical opinion, the ALJ will generally address the source’s medical opinions together in a

single analysis. 20 C.F.R. §§ 404.1520c(b)(1), 416.920c(b)(1).

“An ALJ can satisfy the substantial evidence requirement by setting out a detailed and

thorough summary of the facts and conflicting clinical evidence, stating his interpretation

thereof, and making findings.” Garrison v. Colvin, 759 F.3d 995, 1012 (9th Cir. 2014). In other

words, “[t]he ALJ must do more than offer his conclusions . . . [h]e must set forth his own

interpretations and explain why they, rather than the doctors’, are correct.” Reddick v. Chater,

157 F.3d 715, 725 (9th Cir. 1998). “Although [the reviewing court] will not fault the agency

merely for explaining its decision with less than ideal 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, 492 (9th Cir. 2017) (internal citation and quotation marks omitted).

B. Dr. Alvord

Dr. Alvord met with plaintiff three times to conduct consultative examinations, first on

June 29, 2021, then on May 11, 2022, and finally on December 21, 2022. Tr. 437-39, 443-48,

1674-79. In his report of their second consultation, Dr. Alvord provided a capability statement

and functional assessment stating plaintiff is “capable of managing his own funds” and would

have: “moderate difficulty understanding, carrying out, and remembering instructions (both

complex and one-two step)”; “moderate to marked difficulty sustaining concentration and

persisting in work related activity at a reasonable pace”; “moderate to marked difficulty [to]

maintain effective social interaction on a consistent and independent basis with supervisors, co-

workers, and in the public”; and “moderate to marked difficulty dealing with normal pressures in

a competitive work setting.” Tr. 447. The ALJ found Dr. Alvord’s functional assessment “less

persuasive” because it was unsupported by Dr. Alvord’s clinical findings and inconsistent with

mental health treatment notes from the same period. Tr. 23. The ALJ’s conclusion was supported

by substantial evidence.

First, the ALJ noted how Dr. Alvord’s assessment of plaintiff having “moderate difficulty

understanding, carrying out, and remembering” even “one-two step” instructions is unsupported

by Dr. Alvord’s own findings. Tr. 23, 446. The ALJ explained how Dr. Alvord provided “no

clinical signs suggesting the claimant would struggle with simple unskilled tasks” and,

contrarily, Dr. Alvord reported plaintiff performed a panel of memory, attention, concentration,

and general information without error. Tr. 23, 445. Plaintiff also exhibited intellectual ability in

the “low average” IQ range and had adequate long-term, short-term, and immediate working

memory. Tr. 23, 446. There were no signs plaintiff would struggle with simple unskilled tasks.

Tr. 23, 445-47.

The ALJ continued to explain how Dr. Alvord’s assessments of plaintiff having difficulty

maintaining social interaction and dealing with normal workplace pressures are “inconsistent”

with Dr. Alvord’s findings plaintiff has cyclical moods, sometimes enjoys socializing, exhibited

normal thought process, and was pleasant and cooperative throughout his examination. Tr. 22-

23, 445-46. Because the ALJ provided substantial evidence explaining how Dr. Alvord’s

assessment was unsupported by Dr. Alvord’s findings, the ALJ properly addressed the

supportability factor.

Second, the ALJ addressed the consistency of Dr. Alvord’s opinion. Tr. 23. The ALJ

found Dr. Alvord’s opinion less persuasive because it was inconsistent with mental health

treatment notes from other providers during the same period. Id. While Dr. Alvord provided the

limiting functional assessments described above, mental health professionals at the time

described plaintiff as cooperative, fully oriented, appropriate, and logical. Tr. 23, 2104, 2111.

The ALJ cited treatment notes from the time describing plaintiff’s “mental status as ‘stable for

several months’” Tr. 23 (quoting Tr. 2102, 2109). The ALJ continued to cite records from the

period describing plaintiff as open, engaged, and adequately groomed while exhibiting a linear,

goal-directed, and logical thought process—despite occasional anxiety and recurring depression.

Tr. 23, 2117. Due to these inconsistencies with the record, the ALJ found Dr. Alvord’s opinion

less persuasive.

Thus, the ALJ’s finding of Dr. Alvord’s opinion to be less persuasive complied with the

regulations governing the Commissioner’s evaluation of medical opinions and was supported by

substantial evidence.

C. Mr. Rosenthal, QMHP

Mr. Rosenthal, QMHP, treated plaintiff once or twice a week for over two years. Tr. 23,

2394. The ALJ summarized Mr. Rosenthal’s June 2023 report on plaintiff which stated plaintiff

was unable to function in a work setting due to severe depression, anxiety, nightmares, insomnia,

panic, emotional dysregulation, mutism, and trauma triggers. Tr. 23, 2395. Mr. Rosenthal also

reported plaintiff would be excessively absent from work due to these symptoms. Tr. 23, 2399.

The ALJ found Mr. Rosenthal’s assessment less persuasive because of “apparent discrepancy”

between Mr. Rosenthal’s assessment, his own treatment records, and observations of other

medical providers. Tr. 23-34. The ALJ’s conclusion was supported by substantial evidence.

First, the ALJ addressed the supportability factor by citing to Mr. Rosenthal’s treatment

notes inconsistent with Mr. Rosenthal’s June 2023 assessment of plaintiff. Tr. 23. The ALJ noted

how Mr. Rosenthal repeatedly observed plaintiff to be “cooperative, fully oriented, appropriate

appearing, and logical” over the course of five visits between November 2022 and January 2023.

Tr. 23, 2097, 2104, 2111, 2151, 2166. The ALJ then reasonably highlighted how “[i]t is therefore

unclear how the treatment provider arrived at the conclusion the claimant would be mentally

unable to tolerate competitive employment.” Tr. 23-24.

Second, the ALJ addressed the consistency factor by citing to “contemporaneous clinical

observations” by other treatment providers inconsistent with Mr. Rosenthal’s medical opinion.

Tr. 24. The ALJ noted how other treatment providers similarly observed plaintiff to be “‘calm,’

‘cooperative, open and engaged.’” Tr. 24 (quoting 2117, 2157). Therefore, the ALJ properly

applied the regulations in finding Mr. Rosenthal’s opinion less persuasive.

Plaintiff argues the ALJ improperly focused on “certain ‘objective’ evidence” while

assessing Mr. Rosenthal’s medical opinion. Pl. Br. at 5. Plaintiff argues the ALJ erred by not

citing to Mr. Rosenthal’s treatment records reporting plaintiff's instances of selective mutism. /d.

However, it is the ALJ’s duty, not this Court’s, to resolve ambiguities in the medical evidence.

Tommasetti v. Astrue, 533 F.3d 1035, 1041-42 (9th Cir. 2008) (‘The ALJ is the final arbiter with

respect to resolving ambiguities in the medical evidence.”’); “The ALJ ‘is responsible for

determining credibility, resolving conflicts in medical testimony, and for resolving

ambiguities.” Ford v. Saul, 950 F.3d 1141, 1149 (9th Cir. 2020) (quoting Andrews v. Shalala,

53 F.3d 1035, 1039 (9th Cir. 1995)).

Because the ALJ’s assessment of Mr. Rosenthal’s opinion was reasonable and supported

by substantial evidence, it is affirmed. Garrison, 759 F.3d at 1010 (“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.” (citation and internal quotation and brackets omitted)).

CONCLUSION

Based on the foregoing, pursuant to 42 U.S.C. § 405(g), sentence four, the Court

AFFIRMS the Commissioner’s decision.

IT IS SO ORDERED.

DATED this 27th day of June, 2025. IA (S\N

ANDREW HALLMAN

United States Magistrate Judge

PAGE 17 —- OPINION AND ORDER