“[T]he ALJ has a special duty to 9 develop the record fully and fairly and to ensure that the claimant’s interests 10 are considered, even when the claimant is represented by counsel.”
How later courts described this case
- “[T]he ALJ has a special duty to 9 develop the record fully and fairly and to ensure that the claimant’s interests 10 are considered, even when the claimant is represented by counsel.”
- “Even under the new 10 regulations, an ALJ cannot reject an examining or treating doctor’s opinion as 11 unsupported or inconsistent without providing an explanation supported by 12 substantial evidence.”
- “[I]t is a questionable 16 practice to chastise one with a mental impairment for the exercise of poor 17 judgment in seeking rehabilitation.”
- “a nonprecedential disposition is not appropriately used . . . as the pivotal 28 basis for a legal ruling by a district court”
Written by the judges who cited it.
The opinion
1
2
3
4
5
6
7
8 UNITED STATES DISTRICT COURT
9 CENTRAL DISTRICT OF CALIFORNIA
10
11 Case No. 2:24-cv-09766-PD
WILLIE Q. W.,1
12 Plaintiff,
MEMORANDUM OPINION
13 v.
AND ORDER AFFIRMING
14 FRANK BISIGNANO,2 AGENCY DECISION
15 COMMISSIONER OF SOCIAL SECURITY,
16 Defendant.
17
18
Plaintiff challenges the denial of his applications for Social Security
19
Disability Insurance Benefits (“DIB”) and Supplemental Security Income
20
(“SSI”). For the reasons stated below, the decision of the Administrative Law
21
Judge is affirmed.
22
23
24
1 Plaintiff’s name is partially redacted in accordance with Federal Rule of
25
Civil Procedure 5.2(c)(2)(B) and the recommendation of the United States Judicial
26 Conference Committee on Court Administration and Case Management.
27 2 Frank Bisignano became the Commissioner of Social Security on May 6,
2025, and is substituted as Defendant in this suit. See 42 U.S.C. § 405(g).
28
1 I. Pertinent Procedural History and Disputed Issues
2
On July 6 and November 24, 2021, Plaintiff filed applications for SSI
3
and DIB, respectively. [Administrative Record (“AR”) 272, 281.3] Plaintiff
4
alleges that he became disabled and unable to work on January 1, 2019. [Id.]
5
Plaintiff’s application was denied on April 26, 2022 and upon reconsideration
6
on May 20, 2022. [AR 168, 179.] Plaintiff requested a hearing, which was
7
held before an Administrative Law Judge (“ALJ”) on December 1, 2023. [AR
8
46.] Plaintiff appeared with counsel, and the ALJ heard testimony from
9
Plaintiff and a vocational expert (“VE”). [AR 46-47.] On January 30, 2024,
10
the ALJ issued a decision finding that Plaintiff was not disabled under the
11
Social Security Act (“SSA”). [AR 40.] The Appeals Council denied Plaintiff’s
12
request for review on October 4, 2024, rendering the ALJ’s decision the final
13
decision of the Commissioner. [AR 1.]
14
The ALJ followed the five-step sequential evaluation process to assess
15
whether Plaintiff was disabled under the SSA. Lester v. Chater, 81 F.3d 821,
16
828 n.5 (9th Cir. 1995), superseded on other grounds by regulation, Revisions
17
to Rules Regarding the Evaluation of Medical Evidence, 82 Fed. Reg. 5844,
18
5852 (Jan. 18, 2017) (codified at 20 C.F.R. pts. 404 & 416), as recognized in
19
Farlow v. Kijakazi, 53 F.4th 485, 488 (9th Cir. 2022).
20
At step one, the ALJ found that there has been a continuous 12-month
21
period in which Plaintiff had not engaged in substantial gainful activity,
22
which began after September 2021. [AR 19-20.]
23
At step two, the ALJ found that Plaintiff had the following severe
24
impairments: “schizoaffective disorder, paranoid schizophrenia, anxiety, and
25
bipolar I disorder (20 CFR 404.1520(c) and 416.920(c)).” [AR 20.] The ALJ
26
found the medically determinable impairments significantly limit Plaintiff’s
27
28 3 The Administrative Record is at Docket Numbers 14-1 through 14-8.
1 ability to perform basic work activities. [Id.] After considering the record, the
2
ALJ also found that the following were not medically determinable
3
impairments: major depression with psychosis, substance-induced psychosis
4
(compounding primary illness), multiple dermoid cysts in the scalp post
5
dermoid cyst removal, nonspecific headaches, a herniated disc, and migraines.
6
[AR 20-22.]
7
At step three, the ALJ found that Plaintiff “does not have an
8
impairment or combination of impairments that meets or medically equals the
9
severity of one of the listed impairments in 20 CFR Part 404, Subpart P,
10
Appendix 1 (20 CFR 404.1520(d), 404.1525, 404.1526, 416.920(d), 416.925 and
11
416.926).” [AR 22.]
12
Before proceeding to step four, the ALJ determined that Plaintiff has
13
the Residual Functional Capacity (“RFC”) to “perform a full range of work at
14
all exertional levels but with the following nonexertional limitations”:
15 [H]e can handle occasional changes in a routine work setting and
use judgment to make simple decisions. He cannot perform work
16
requiring a specific production rate, such as assembly-line work,
17 or work that requires hourly quotas, but he can perform goal-
oriented work that can be completed by the end of the work shift.
18
He can have occasional interaction with supervisors and co-
19 workers, in a job working primarily with things rather than
people, and no interaction with general public.
20
[AR 25.]
21
At step four, the ALJ found that Plaintiff is unable to perform his past
22
relevant work as a concession vendor, either as actually or generally
23
performed. [AR 38-39.]
24
At step five, considering Plaintiff’s age, education, work experience, and
25
RFC, the ALJ found there are jobs which exist in significant numbers in the
26
national economy that Plaintiff can perform, in the occupations of “night
27
cleaner,” “dishwasher,” and “furniture stripper.” [AR 39.] Accordingly, the
28
1 ALJ concluded that Plaintiff has not been under a disability as defined in the
2 SSA from January 1, 2019 through the date of the ALJ’s decision. [AR 40.]
3 Plaintiff raises two issues: first, whether the ALJ provided clear,
4 convincing, and well-supported reasons for discounting Plaintiff’s subjective
5 symptom testimony as to his mental dysfunction; and second, whether the
6 ALJ adequately explained departing from the prior administrative medical
7 findings of Dr. Heather Abrahimi, Psy.D. in crafting the RFC. [Dkt. No. 15 at
8 6, 14.]
9
II. Standard of Review
10
Under 42 U.S.C. § 405(g), a district court may review the agency’s
11
decision to deny benefits. A court will vacate the agency’s decision “only if the
12
ALJ’s decision was not supported by substantial evidence in the record as a
13
whole or if the ALJ applied the wrong legal standard.” Coleman v. Saul, 979
14
F.3d 751, 755 (9th Cir. 2020) (citation and internal quotation marks omitted).
15
“Substantial evidence means more than a mere scintilla but less than a
16
preponderance; it is such relevant evidence as a reasonable person might
17
accept as adequate to support a conclusion.” Id. (citation and internal
18
quotation marks omitted); Biestek v. Berryhill, 587 U.S. 97, 103 (2019) (same).
19
It is the ALJ’s responsibility to determine credibility and to resolve
20 conflicts in the medical evidence and ambiguities in the record. Ford v. Saul,
21 950 F.3d 1141, 1149 (9th Cir. 2020). “Where evidence is susceptible to more
22 than one rational interpretation,” the ALJ’s reasonable evaluation of the proof
23 should be upheld. Ryan v. Comm’r of Soc. Sec., 528 F.3d 1194, 1198 (9th Cir.
24 2008); Tran v. Saul, 804 F. App’x 676, 678 (9th Cir. 2020).4
25
26 4 Although statements in unpublished Ninth Circuit opinions “may prove
useful [] as examples of the applications of settled legal principles,” the Ninth Circuit
27
has cautioned lower courts not to rely heavily on such memorandum dispositions
28 particularly as to issues of law. Grimm v. City of Portland, 971 F.3d 1060, 1067 (9th
1 Error in Social Security determinations is subject to harmless error
2 analysis. Ludwig v. Astrue, 681 F.3d 1047, 1054 (9th Cir. 2012). Error is
3 harmless if it is “inconsequential to the ultimate nondisability determination”
4 or, despite the legal error, “if the agency’s path may reasonably be discerned.”
5 Treichler v. Comm’r of Soc. Sec. Admin., 775 F.3d 1090, 1099 (9th Cir. 2014)
6 (citation and internal quotation marks omitted).
7
III. Discussion
8
A. The ALJ Did Not Err in Discounting Plaintiff’s
9 Subjective Symptom Testimony
10 Plaintiff argues the ALJ erred by discounting his subjective symptom
11 testimony as to his mental dysfunction. [AR 15 at 6.]
12
1. Relevant Law
13
“To determine whether a claimant’s subjective symptom testimony is
14
credible, the ALJ must engage in a two-step analysis: ‘First, the ALJ must
15
determine whether the claimant has presented objective medical evidence of
16
an underlying impairment which could reasonably be expected to produce the
17
pain or other symptoms alleged.’” Ferguson v. O’Malley, 95 F.4th 1194, 1199-
18
1200 (9th Cir. 2024) (quoting Garrison v. Colvin, 759 F.3d 995, 1014 (9th Cir.
19
2014)). If step one is satisfied and there is no evidence of malingering, the
20
ALJ can only reject the claimant’s subjective symptom testimony “by offering
21
specific, clear and convincing reasons for doing so.” Id. (citation and internal
22
quotation marks omitted).
23 At step two, an ALJ must identify which testimony is not credible and
24 “link that testimony to the particular parts of the record supporting her non-
25 credibility determination.” Brown-Hunter v. Colvin, 806 F.3d 487, 494 (9th
26
27
Cir. 2020) (“a nonprecedential disposition is not appropriately used . . . as the pivotal
28 basis for a legal ruling by a district court”).
1 Cir. 2015); accord Ferguson, 95 F.4th at 1200. “This is not an easy
2 requirement to meet: ‘The clear and convincing standard is the most
3 demanding required in Social Security cases.’” Garrison, 759 F.3d at 1015
4 (quoting Moore v. Comm’r of Soc. Sec. Admin., 278 F.3d 920, 924 (9th Cir.
5 2002)); see also Smartt v. Kijakazi, 53 F.4th 489, 499 (9th Cir. 2022)
6 (“Ultimately, the ‘clear and convincing’ standard requires an ALJ to show
7 [their] work[.]”). Thus, to satisfy the substantial evidence standard, the ALJ
8 must provide specific, clear, and convincing reasons which explain why the
9 medical evidence is inconsistent with the claimant’s subjective symptom
10 testimony. Ferguson, 95 F.4th at 1200 (emphasis in original).
11 A court must “review only the reasons provided by the ALJ in the
12 disability determination and may not affirm the ALJ on a ground upon which
13 [they] did not rely.” Orn v. Astrue, 495 F.3d 625, 630 (9th Cir. 2007). The
14 court “may not take a general finding — an unspecified conflict between
Claimant’s testimony about daily activities and her reports to doctors — and
15
comb the administrative record to find specific conflicts.” See Burrell v.
16
Colvin, 775 F.3d 1133, 1138 (9th Cir. 2014). ALJs must instead point to
17
specific facts in the record to find a lack of credibility, and such findings are
18
insufficiently specific where they are general, unspecified, and/or made in
19
passing in a different section than the credibility determination. Id.
20
An ALJ can consider whether there is a lack of objective medical
21
evidence supporting a claimant’s allegations. However, this factor “cannot
22
form the sole basis” for discounting subjective symptom testimony. Burch v.
23
Barnhart, 400 F.3d 676, 681 (9th Cir. 2005); Davis v. Berryhill, 736 F. App’x
24
662, 665 (9th Cir. 2018).
25
When there is an error with one of the grounds the ALJ relied upon,
26
“the relevant inquiry in this context is . . . whether the ALJ’s decision remains
27
legally valid, despite such error.” Carmickle v. Comm’r, Soc. Sec. Admin., 533
28
1 F.3d 1155, 1162 (9th Cir. 2008). If an ALJ impermissibly relies “on one of
2 several reasons in support of an adverse credibility determination,” the error
3 is harmless if “the ALJ’s remaining reasoning and ultimate credibility
4 determination were adequately supported by substantial evidence in the
5 record.” Id. at 1162 (emphasis omitted).
6
2. Plaintiff’s Subjective Symptom Testimony
7
Plaintiff was formerly a food and alcohol cashier who worked at Angel
8
Stadium in Anaheim and Dodger’s Stadium in Los Angeles. [AR 59, 62.] The
9
ALJ asked Plaintiff what problems are keeping him from being able to work.
10
[AR 64.] Plaintiff pointed to mental issues, head issues, and physical issues
11
with his back and his knee. [Id.]
12
a) Mental Issues
13
14 As to mental issues, Plaintiff discussed them throughout the hearing.
15 He noted his first mental break was on January 1, 2019. [AR 57-58.] He was
16 laid off in 2021 because there were times when he was tardy or could not
17 make it into work due to his stress and anxiety. [AR 61-62.] In September
2023, Plaintiff tried to take a security job. [AR 62.] That lasted about two
18
weeks because his legs hurt from long standing periods; his energy levels,
19
anxiety, and mood swings made it difficult for him to get out of bed; and his
20
commute was three hours each way. [AR 62-63.]
21
At some point after his mental break, he began to use
22
methamphetamines to get by and keep his mind focused. [AR 68.] In March
23
2021, his mother and sister placed him on a 5150 psychiatric hold. [AR 68-
24
69.] According to Plaintiff, they did so because they heard him talking to
25
himself and saying that he felt worthless and did not want to live, but that he
26
was not yelling, did not have a knife, and did not say he wanted to kill
27
himself. [AR 69.] After the 5150 hold, Plaintiff started taking medications
28
1 and stopped taking methamphetamines, which gave him less stress, less
2 anxiety, and a clear mind. His medications included Abilify,5 and they
3 changed over time as his doctors tried trial and error to see what worked best
4 for him. [AR 73-74.] Plaintiff had a hospital admission in January 2022. [AR
5 73.] This was because his prescribing psychiatrist went on vacation, and
6 Plaintiff did not have a way to get his medications for nine weeks. [Id.] The
7 hospital put Plaintiff back on Abilify and his other medications, which helped
8 him. [Id.] In July 2022, Plaintiff relapsed on methamphetamines because his
9 mother was hospitalized due to her own medical issues, which emotionally
10 triggered Plaintiff because Plaintiff’s father died when Plaintiff was 15 years
11 old. [Id.] In June 2023, Plaintiff had a 24-hour emergency room visit for
12 panic attacks and anxiety. [AR 74-75.] At some point in 2023, he had spent
13 62 days in rehabilitation to make sure he would not slip up with alcohol
14 issues, substance abuse, and anger management. [AR 78.] He also discussed
going to the rehab because he did not have somewhere to live. [Id.]
15
As of the hearing, Plaintiff took Abilify (400 mg monthly), Zoloft (150
16
mg daily),6 and Depakote (500 mg daily).7 [AR 71.] Plaintiff also discussed
17
how he tries to be on top of taking his daily medications because they really
18
19
5 Abilify (generic: aripiprazole) injection is used to treat agitation caused by
20 schizophrenia or bipolar mania. Mayo Clinic, https://www.mayoclinic.org/drugs-
supplements/aripiprazole-intramuscular-route/description/drg-20069716 (last visited
21
Aug. 20, 2025).
22
6 Zoloft (generic: sertraline) is used to treat depression, obsessive-compulsive
23 disorder (OCD), panic disorder, premenstrual dysphoric disorder (PMDD),
posttraumatic stress disorder (PTSD), and social anxiety disorder (SAD). Mayo
24
Clinic, https://www.mayoclinic.org/drugs-supplements/sertraline-oral-
25 route/description/drg-20065940 (last visited Aug. 20, 2025).
26 7 Depakote (generic: divalproex sodium) is used to treat certain types of
seizures, to treat the manic phase of bipolar disorder, and to help prevent migraine
27
headaches. Mayo Clinic, https://www.mayoclinic.org/drugs-supplements/divalproex-
28 sodium-oral-route/description/drg-20072886 (last visited Aug. 20, 2025).
1 help him and if he does not take them his days get “really bad.” [Id.]
2
b) Head Issues
3
Plaintiff has headaches. [AR 66.] Plaintiff, who was 33 years old at the
4
time of the hearing, discussed having nine different surgeries on his head
5
because of cancer, which he had when he was 18 or 19 years old. [AR 55, 65.]
6
He had the same type of cancerous growths that killed his father. [AR 65.]
7
Plaintiff also underwent chemotherapy and radiation; he is now cancer free.
8
[AR 65-66.] Even though his hair grew back after he lost all of it, it did not
9
come back the way it had been. [AR 65.] Plaintiff’s head still bleeds at night
10
because the cyst sites never recovered. [AR 82.] They will also bleed if he
11
gets “too much excitement or too much pressure.” [Id.]
12
In addition to physical head pain, he gets depressed and panicked about
13
his head. [AR 82.] He is self-conscious of how he looks: he feels like a
14
“monster” some days because of what he looks like and recalls a woman
15
telling him that he looks “almost like Frankenstein.” [AR 65, 82.] He wears
16
beanies and hats so that no one will see his head. [AR 82.] However, Plaintiff
17
did not recall having any treatment for headaches in the last two or three
18
years. [AR 66.] He testified to trying to “tough it out or stick it out because
19
ultimately [he doesn’t] want to think about having the same issues again”
20 because they terrify him. [Id.]
21
c) Back and Knee Issues
22
When Plaintiff was employed as a cashier, he sold food and alcohol,
23
which required him to be on his feet his entire shift. [AR 60.] Because he sold
24
beer, he had to move kegs weighing about 80 to 150 pounds daily, which
25
caused him to pull his back. [AR 60-61.]
26
Plaintiff stated he had “really bad back pain” and “really bad knee
27
pain.” [AR 64.] Plaintiff repeated this claim later in his testimony, and he
28
1 also indicated back and mobility issues in his Function Report. [AR 72, 361,
2 366.] The ALJ asked him if he had any treatment for his back or his knees.
3 [Id.] Plaintiff responded that he had not. Plaintiff’s counsel subsequently
4 asked Plaintiff about what helped he required from others, to which Plaintiff
5 responded that he needed help with mobility, including “getting up in the
6 morning” and “getting around.” [AR 81.] Counsel asked if Plaintiff had ever
7 been given a brace or an assistive device; Plaintiff answered that he would
8 “love one” but had not been offered any. [Id.] This corresponded with
9 Plaintiff’s non-responses in his Function Report to whether he used various
10 assistive devices, such as crutches, a cane, a walker, or a wheelchair. [AR
11 367.]
12
3. The ALJ’s Findings
13
The ALJ discussed Plaintiff’s subjective symptom testimony when
14
summarizing the medical evidence. [AR 26-34.] While the ALJ noted
15
Plaintiff’s testimony that “his mood swings and anxiety along with problems
16
with his back, head, and knee keep him from working”, the ALJ focused the
17
summary on Plaintiff’s mental impairments because the ALJ did not find at
18
step two that he had any physical severe impairments. [AR 20-22, 33.]
19
The ALJ found “claimant’s allegations of mental impairments are
20 somewhat persuasive.” [AR 34.] Accordingly, the ALJ included multiple
21 nonexertional limitations into the RFC. [Id.]
22 However, the ALJ also determined that “the medical evidence does not
23 support any further limitations.” [Id.] The ALJ provided three reasons in
24 support of this conclusion. First, after noting the existence of and reasons for
25 significant gaps in the record regarding his history of mental health
26 treatment, “the records and his testimony indicate he was overall doing better
27 and stable when taking his psychiatric medications and not using drugs or
28
1 alcohol. His psychiatric hospitalizations all seemed related to non-compliance
2 with medications and/or drug and alcohol abuse.” [Id.] Second, “[t]here is no
3 indication in the record that he ever had any therapy or counseling except a
4 few visits in the fall of 2023.” [Id.] Finally, “[a]s for the claimant’s statements
5 about the intensity, persistence, and limiting effects of his symptoms, they are
6 inconsistent because when he was on psychiatric [medications] and sober, the
7 results of [his] mental status examinations are consistent with the above
8 residual functional capacity.” [AR 34-35.]
9
4. The Parties’ Arguments
10
Plaintiff argues the ALJ erred in discounting Plaintiff’s mental
11
subjective symptom testimony.8 [Dkt. No. 15 at 9.] According to Plaintiff, the
12
ALJ inferred his mental symptoms were not disabling because he did not
13
pursue consistent treatment and did not follow through with outpatient care,
14
which ignored the impact of Plaintiff’s psychosis. [Id. at 10 (citing Van
15
Nguyen v. Chater, 100 F.3d 1462, 1465 (9th Cir. 1996) (“[I]t is a questionable
16
practice to chastise one with a mental impairment for the exercise of poor
17
judgment in seeking rehabilitation.”) (internal quotation marks and citation
18
omitted)).] Plaintiff points to his repeated hospitalizations, rehabilitations,
19
and outpatient treatments from 2021 through 2023 as evidence of the severity
20 of his mental impairments. [Id. at 6-9.] Plaintiff further argues that the
21 overall medical record demonstrates that his psychotic symptoms were
22 disabling, even when he was medicated and not on drugs. [Id. at 10-13.]
23 Plaintiff points to various parts of the medical record in support of this
24 argument. [Id.]
25
26
27
8 Plaintiff does not argue that the ALJ erred as to discounting Plaintiff’s
28 subjective symptom testimony regarding his physical symptoms.
1 Plaintiff also raises a procedural issue. Plaintiff argues the ALJ erred
2 because the ALJ “must apply Social Security Rulin[g] 13-2p and evaluate
3 whether the claimant is disabled with such substance use or alcoholism” if the
4 ALJ “believed that Plaintiff’s use of illicit drugs and/or alcohol materially
5 contributed to his acute psychosis leading to psychiatric hospitalizations[.]”
6 [Id. at 11 (emphasis omitted).] According to Plaintiff, the ALJ committed
7 “harmful legal error” by not following SSR 13-2p because proper application of
8 SSR 13-2p would have shown Plaintiff’s psychotic symptoms and periods of
9 acute schizophrenia persisted even while he was abstaining from the use of
10 illicit drugs. [Id. at 12.]
11 The Commissioner argues, “[t]he ALJ thoroughly discussed the evidence
12 that was available and acknowledged that the record contained abnormal
13 findings on the mental status examinations (MSE) during Plaintiff’s
14 hospitalizations but also noted with treatment and ongoing sobriety those
findings generally normalized during his stays.” [Dkt. No. 16 at 8.] The
15
Commissioner also argues that Plaintiff’s argument regarding SSR 13-2p “is a
16
red herring” because “[t]he ALJ did not find Plaintiff’s drug addiction or
17
alcoholism to be material [and] the State agency medical consultants found no
18
evidence of a DAA9 issue, and therefore the analysis in SSR 13-2p is not
19
relevant.” [Id. at 8-9.]
20
21 5. The ALJ Did Not Err When Discounting the
Subjective Symptom Testimony
22
The ALJ provided two specific, clear, and convincing reasons why
23
Plaintiff’s subjective symptom testimony as to the intensity, persistence, and
24
limiting effects of his mental issues was partially inconsistent with the
25
26
9 “DAA” is short for “drug addiction and alcoholism.” See SSR 13-2p: Titles II
27
and XVI: Evaluating Cases Involving Drug Addiction and Alcoholism (DAA).
28
1 medical evidence.10 [AR 34-35.] See Ferguson, 95 F.4th at 1200.
2 The first reason is that the overall medical record (including
3 consideration of the gaps and the reasons for those gaps) showed Plaintiff did
4 well when medicated and when not on drugs, and poorly (to the point of
5 hospitalization) when unmedicated or on drugs. This is a specific, clear, and
6 convincing reason because it would show a direct contradiction between
7 Plaintiff’s claim that he is too disabled to work because of his mental
8 impairments and objective medical evidence showing that he is able to work
9 when (1) he has unimpeded access to his prescribed psychiatric medications,
10 (2) he is consistently taking his prescribed psychiatric medications, and (3) he
11 is consistently not taking drugs. Although mental illnesses could theoretically
12 impede a claimant’s ability to consistently take their prescribed medications,
13 the ALJ discussed in the decision how that was not what the evidence showed
14 in this case. Substantial evidence from the medical record supports the ALJ’s
finding on this point, and that evidence was cited in the ALJ’s decision. [AR
15
35 (citing AR 463, 495-506, 514-16, 575-84, 604-21, 626-27, 633-36, 638, 651,
16
672-76, 742-44).]
17
Contrary to Plaintiff’s argument, the ALJ did not ignore the impact of
18
Plaintiff’s psychosis and made an inference about Plaintiff’s mental symptoms
19
based on the absence of certain treatment records. Rather, the ALJ’s robust
20
and nuanced decision indicates that ALJ grappled thoughtfully with all of the
21
evidence in the record — including the credible portions of Plaintiff’s
22
subjective symptom testimony, the existing portions of the medical record,
23
and the reasons Plaintiff stated as to why other portions of the medical record
24
did not exist — before crafting the RFC. [AR 25-38.] To the extent there were
25
26
10 As noted above, the ALJ found Plaintiff’s subjective symptom testimony
27
“somewhat persuasive” and did include multiple nonexertional limitations based on
28 the testimony and the rest of the record evidence.
1 inadequacies and/or ambiguities posed by the absence of certain records, they
2 were cleared up at the hearing by the ALJ, who thoroughly inquired as to the
3 various medical records and periods in this matter. [AR 58-59 (ALJ asking
4 about lack of medical records from 2018 to 2021), AR 64-65 (ALJ asking about
5 lack of medical records for back and knee issues), AR 65-66 (ALJ asking about
6 Plaintiff’s cancer and headache treatments), AR 67-82 (ALJ asking about
7 Plaintiff’s mental issues, hospitalizations, and medications).] Accord Mayes v.
8 Massanari, 276 F.3d 453, 459 (9th Cir. 2001) (“[T]he ALJ has a special duty to
9 develop the record fully and fairly and to ensure that the claimant’s interests
10 are considered, even when the claimant is represented by counsel.”). As the
11 ALJ posits a rational interpretation that is supported by substantial evidence,
12 the ALJ’s reasonable evaluation should be upheld. Ryan, 528 F.3d at 1198.
13 The second reason is that the results of Plaintiff’s mental status
14 examinations were consistent with the RFC. This is a specific, clear, and
convincing reason because it would show a direct contradiction between
15
Plaintiff’s claim that he is too disabled to work because of his mental
16
impairments and evidence that he can work within certain nonexertional
17
limitations. In the decision, the ALJ repeatedly discussed multiple mental
18
status examinations, including those taken by Mario Pacheco, N.P. on
19
January 21, 2022; Dr. Stephen Erhart on January 25, 2022; Eunice Lee,
20
P.M.H.N.P.11 from February 2022 to July 2022; and Dr. Leilani Sharpe in
21
August 2023. [AR 22-31.] Plaintiff only cites one mental examination from
22
when Plaintiff was hospitalized in April 2021 and does not make arguments
23
as to any of these mental status examinations. Substantial evidence from
24
these mental status examinations supports the ALJ’s finding that Plaintiff
25
should have some, but not complete, nonexertional limitations in the RFC.
26
27
11 P.M.H.N.P. is the acronym for Psychiatric Mental Health Nurse
28 Practitioner.
1 The ALJ also gave a third reason for discounting Plaintiff’s subjective
2 symptom testimony -- that there was “no indication in the record that he ever
3 had any therapy or counseling except a few visits in the fall of 2023.” [AR 34.]
4 However, the record demonstrates Plaintiff was hospitalized multiple times
5 since the onset of his mental illnesses. As noted earlier in the ALJ’s decision,
6 Plaintiff received individual, group, and milieu therapy during his March
7 2021 hospitalization and individual, group, and adjunctive therapy during his
8 January 6, 2022 hospitalization. [AR 27 (citing AR 514), 28 (citing AR 530-
9 55).] The record on whether Plaintiff sought therapy or counseling is
10 ambiguous, and the ALJ did not resolve the ambiguity in the decision. Thus,
11 the ALJ did not give a specific, clear, and convincing reason for discounting
12 Plaintiff’s subjective symptom testimony when citing his therapy and
13 counseling visits.
14 In summary, the ALJ gave two specific, clear, and convincing reasons
for discounting Plaintiff’s subjective symptom testimony: the overall medical
15
record showed Plaintiff did well when on medications and when not on drugs,
16
and poorly when unmedicated or on drugs; and the results of Plaintiff’s
17
mental status examinations were consistent with the RFC. These two reasons
18
are sufficient to uphold the ALJ’s discounting of the subjective symptom
19
testimony. Burch, 400 F.3d at 681. Accordingly, the ALJ did not err in
20
discounting Plaintiff’s subjective symptom testimony.
21
Finally, as to the procedural issue, the Commissioner “make[s] a DAA
22
materiality determination only when: i. [the Commissioner has] medical
23
evidence from an acceptable medical source establishing that a claimant has a
24
Substance Use Disorder, and ii. [the Commissioner] find[s] that the claimant
25
is disabled considering all impairments, including the DAA.” SSR 13-2p, 3.a.
26
Here, the ALJ did not establish that Plaintiff had a substance abuse disorder.
27
To the contrary, the ALJ rejected a finding that Plaintiff had a severe
28
1 impairment of substance-induced psychosis (compounding primary illness).
2 [AR 20.] Because the ALJ did not find that Plaintiff had a substance use
3 disorder, the ALJ was not required to conduct a DAA analysis pursuant to
4 SSR 13-2p, and the ALJ did not err by omitting that analysis from the
5 decision.
6
B. The ALJ Did Not Err When Departing from Dr.
7 Abrahimi’s Prior Administrative Medical Findings in
Crafting the RFC
8
Plaintiff argues the ALJ erred by departing without explanation from
9
the prior administrative medical findings of Dr. Abrahimi, the State agency
10
psychologist who reviewed Plaintiff’s DIB and SSI applications on
11
reconsideration.12 [Dkt. No. 15 at 14.]
12
1. Relevant Law
13
14 An RFC is “an assessment of an individual’s ability to do sustained
15 work-related physical and mental activities in a work setting on a regular and
16 continuing basis.” Social Security Ruling 96-8P, 1996 WL 374184, at *1 (July
17 2, 1996). It reflects the most a claimant can do despite their limitations.
18 Smolen v. Chater, 80 F.3d 1273, 1291 (9th Cir. 1996). An RFC determination
must be based on all of the relevant evidence, including the diagnoses,
19
treatment, observations, and opinions of medical sources, such as treating and
20
21
22 12 Plaintiff uses the term “medical source opinion” to describe Dr. Abrahimi’s
findings, including her findings as to his RFC. [See Dkt. Nos. 15 at 6, 14-16; 18 at 2-
23 4.] The Court uses the term “prior administrative medical findings” for Dr.
Abrahimi’s findings because that is the term used in the Social Security regulations
24
for findings about medical issues made by the Commissioner’s medical and
25 psychological consultants at a prior level of review based on their review of the
evidence in the case record, including as to claimants’ RFCs. 20 C.F.R. §§
26 404.1513(a)(5)(iv), 416.913(a)(5)(v). For claims filed on or after March 27, 2017,
prior administrative medical findings are considered by ALJs in the same way as
27
medical opinions. See 20 C.F.R. §§ 404.1513a(b)(1), 404.1520c, 416.913a(b)(1),
28 416.920c.
1 examining physicians. 20 C.F.R. § 404.1545. The ALJ is responsible for
2 translating and incorporating supported medical evidence into a succinct
3 RFC. Rounds v. Comm’r Soc. Sec. Admin., 807 F.3d 996, 1006 (9th Cir. 2015).
4 It is the ALJ’s responsibility to resolve conflicts in the medical evidence and
5 ambiguities in the record. Ford, 950 F.3d at 1149. Where this evidence is
6 “susceptible to more than one rational interpretation” the ALJ’s reasonable
7 evaluation of the proof should be upheld. Ryan, 528 F.3d at 1198.
8 The Social Security Administration regulations for claims filed on or
9 after March 27, 2017 apply here. See Revisions to Rules Regarding the
10 Evaluation of Medical Evidence, 82 Fed. Reg. 5844, 2017 WL 168819, at 5844-
11 45 (Jan. 18, 2017). Under these regulations, special deference is no longer
12 given to the opinions of treating and examining physicians on account of their
13 relationship with a claimant, and an ALJ’s “decision to discredit any medical
14 opinion, must simply be supported by substantial evidence.” Woods v.
Kijakazi, 32 F.4th 785, 787 (9th Cir. 2022); 20 C.F.R. §§ 404.1520c(a),
15
416.920c(a) (“We will not defer or give any specific evidentiary weight,
16
including controlling weight, to any medical opinion(s) . . ., including those
17
from [a claimant’s] medical sources.”).
18
The regulations require ALJs to consider and evaluate the
19
persuasiveness of all medical opinions and prior administrative medical
20
findings from medical sources. See 20 C.F.R. §§ 404.1520c(a)-(b), 416.920c(a)-
21
(b). In determining how “persuasive” these opinions and findings are, an ALJ
22
must consider the following factors: supportability, consistency, relationship
23
with claimant, specialization, and other factors that support or contradict the
24
medical opinion or prior administrative medical finding. 20 C.F.R.
25
§§ 404.1520c(c)(1)-(5), 416.920c(c)(1)-(5). “Supportability” and “consistency”
26
are the most important factors to be considered when evaluating the
27
persuasiveness of medical opinions and, therefore, the ALJ is required to
28
1 explain how both factors were considered. See 20 C.F.R. §§ 404.1520c(b)(2),
2 416.920c(b)(2). “Supportability means the extent to which a medical source
3 supports the medical opinion by explaining the ‘relevant . . . objective medical
4 evidence.’” Woods, 32 F.4th at 791-92 (citing 20 C.F.R. § 404.1520c(c)(1)); 20
5 C.F.R. § 416.920c(c)(1). “Consistency means the extent to which a medical
6 opinion is ‘consistent . . . with the evidence from other medical sources and
7 nonmedical sources in the claim.’” Woods, 32 F.4th at 792 (citing 20 C.F.R.
8 § 404.1520c(c)(2)); 20 C.F.R. § 416.920c(c)(2). While the ALJ’s decision must
9 articulate how the ALJ considered supportability and consistency, the
10 decision need not explain the remaining factors unless the ALJ is deciding
11 among differing yet equally persuasive opinions or findings on the same issue.
12 See 20 C.F.R. §§ 404.1520c(b), 416.920c(b); Woods, 32 F.4th at 792.
13 An ALJ must provide an explanation supported by substantial evidence,
14 which articulates how they considered both supportability and consistency.
Kitchen v. Kijakazi, 82 F.4th 732, 739 (9th Cir. 2023); see also Titus L. S. v.
15
Saul, 2021 WL 275927, at *7 (C.D. Cal. Jan. 26, 2021) (ALJ must address how
16
they considered the consistency and supportability factors in sufficient detail
17
to allow a reviewing court to conduct a meaningful review of whether that
18
reasoning is supported by substantial evidence).
19
An RFC is defective if it fails to take a plaintiff’s limitations into
20
account. Valentine v. Comm’r Soc. Sec. Admin., 574 F.3d 685, 690 (9th Cir.
21
2009). However, “[t]here is no requirement that the RFC recite medical
22
opinions verbatim, rather the ALJ is responsible for translating and
23
incorporating medical findings into a succinct RFC.” McIntosh v. Colvin, 2018
24
WL 1101102, at *5 (S.D. Cal. Feb. 26, 2018); see also Foster v. Kijakazi, 2022
25
WL 3230472, at *2 (9th Cir. Aug. 10, 2022) (“An ALJ considers opinions from
26
medical sources on the issue of a claimant’s RFC, but the final responsibility
27
for deciding this issue is reserved to the Commissioner.”) (citations, internal
28
1 quotation marks, and alterations omitted). Finally, it is well established that
2 RFC determinations are legal decisions, not medical opinions. Valerie C. v.
3 Berryhill, 2019 WL 450675, at *6 (C.D. Cal. Feb. 5, 2019).
4
2. Dr. Abrahimi’s Prior Administrative Findings
5
In both the DIB and SSI reconsiderations, Dr. Abrahimi provided the
6
following mental residual functional capacity (“MRFC”):
7
[Claimant] is capable of understanding, remembering and
8 sustaining concentration, pace and persistence for 1-2 step
routines throughout a normal workday/workweek. [Claimant] is
9 able to accept routine supervision and interact with co-workers in
a non-collaborative and superficial basis. [Claimant] is unable to
10 manage the demands of public contact. [Claimant] is capable of
adapting to a routine and predictable work environment,
11 recognizing typical hazards, traveling to routine locations, and
setting goals independently within the framework noted above.
12
[AR 141, 162.] Dr. Abrahimi provided her prior administrative medical
13
findings regarding Plaintiff’s MRFC after evaluating his symptoms and
14 limitations based on the record evidence, including medical opinions in the
15 record. [AR 125-41, 146-62.]
16
3. The ALJ’s Findings and Reasoning
17
The ALJ considered Dr. Abrahimi’s prior administrative medical
18
findings. [AR 37-38.] In doing so, the ALJ discussed the supportability and
19
the consistency of Dr. Abrahimi’s findings, including by reconciling an
20
apparent inconsistency as to Plaintiff’s ability to interact with the general
21
public. [Id.] The ALJ found Dr. Abrahimi’s findings were “overall
22
persuasive.” [AR 38.]
23
After considering the entire record, the ALJ found Plaintiff has the RFC
24
to perform a full range of work at all exertional levels. [AR 25.] However, the
25
ALJ also found Plaintiff’s RFC included the following nonexertional
26
limitations:
27
[H]e can handle occasional changes in a routine work setting and
28
1 use judgment to make simple decisions. He cannot perform work
requiring a specific production rate, such as assembly-line work,
2
or work that requires hourly quotas, but he can perform goal-
3 oriented work that can be completed by the end of the work shift.
He can have occasional interaction with supervisors and co-
4
workers, in a job working primarily with things rather than
5 people, and no interaction with general public.
6 [AR 25.]
7 4. The Parties’ Arguments
8 Plaintiff argues the ALJ made a procedural error in crafting the RFC.
9 Specifically, Plaintiff points to an alleged discrepancy between the ALJ’s RFC
10 (“[H]e can handle occasional changes in a routine work setting and use
11 judgment to make simple decisions”) and Dr. Abrahimi’s MRFC (“[Claimant]
12 is capable . . . for 1-2 step routines”) and claims the ALJ erred by not properly
13 explaining why the ALJ departed from this portion of the MRFC. [Dkt. No. 15
14 at 14-15 (citing Woods, 32 F.4th at 792).] Plaintiff argues this error was not
15 harmless because Dr. Abrahimi’s instruction contemplates occupations
16 requiring a Dictionary of Occupational Titles (“DOT”) reasoning level of one,
17 whereas the ALJ’s instruction (and the three jobs considered by the ALJ at
18 step five) required the higher DOT reasoning level of two. [Id. at 16 (citing
19 Rounds, 807 F.3d at 1003, and Zavalin v. Colvin, 778 F.3d 842, 846-48 (9th
Cir. 2014)).]
20
The Commissioner argues the ALJ properly considered Dr. Abrahimi’s
21
prior administrative medical findings and that substantial evidence supports
22
the ALJ’s evaluation. [Dkt. No. 16 at 11-12.] The Commissioner cites cases
23
from this district and elsewhere for the proposition “that when a State agency
24
consultant finds that a claimant can perform both simple work, and one-to-
25
two-step tasks, an RFC for simple work accounts for the limitations contained
26
in the consultant’s findings because the most a claimant can do based on such
27
a [prior administrative medical finding] would be simple work.” [Id. at 13.]
28
1 The Commissioner cites Stubbs-Danielson v. Astrue, 539 F.3d 1169, 1174-76
2 (9th Cir. 2008) to argue that a limitation to “simple work” accounts for
3 “moderate limitations.” [Id. at 15.] To that end, the Commissioner discusses
4 the various parts of Dr. Abrahimi’s prior administrative medical findings,
5 claims “it is clear that Dr. Abrahimi did not intend to adopt a more restrictive
6 RFC,” and uses that reasoning to justify the ALJ’s finding as to the RFC. [Id.
7 at 14.] Finally, the Commissioner claims “there is no harmful error at step
8 five”, arguing Rounds is inapplicable and the three occupations in this case
9 would be allowed with this RFC under Zavalin. [Id. at 16.]
10
5. The ALJ Adequately Explained the Departure
from Dr. Abrahimi’s MRFC
11
12 The Ninth Circuit has discussed conflicts between RFCs and the
13 nonexertional demands required by certain occupations. Zavalin held “that
14 there is an apparent conflict between the residual functional capacity to
15 perform simple, repetitive tasks, and the demands of Level 3 Reasoning.”
16 Zavalin, 778 F.3d at 847. Rounds held that “[t]here was an apparent conflict
between [a plaintiff’s] RFC, which limit[ed] her to performing one- and two-
17
step tasks, and the demands of Level Two reasoning, which requires a person
18
to ‘[a]pply commonsense understanding to carry out detailed but uninvolved
19
written or oral instructions.’” Rounds, 807 F.3d at 1003. Rounds
20
distinguished between restrictions for “simple” or “repetitive” tasks with “one
21
or step tasks” and concluded an ALJ’s RFC limitation of “one to two step
22
tasks” is not harmless when the occupations proposed at step five involve
23
Level Two reasoning. Id. at 1004.
24
The Court agrees with Plaintiff that the ALJ departed from Dr.
25
Abrahimi’s MRFC. Although the ALJ stated that Dr. Abrahimi’s prior
26
administrative medical findings were “overall persuasive,” the ALJ
27
implemented a less restrictive limitation (“[H]e can handle occasional changes
28
1 in a routine work setting and use judgment to make simple decisions”) into
2 the RFC than that found appropriate by Dr. Abrahimi (“[Claimant] is capable
3 . . . for 1-2 step routines”). See Rounds, 807 F.3d at 1003.
4 By choosing to depart from Dr. Abrahimi’s prior administrative medical
5 finding as to this portion of the MRFC, the ALJ was required to explain the
6 departure. See SSR 96-8p (“The RFC assessment must always consider and
7 address medical source opinions. If the RFC assessment conflicts with an
8 opinion from a medical source, the adjudicator must explain why the opinion
9 was not adopted.”); see also Woods, 32 F.4th at 792 (“Even under the new
10 regulations, an ALJ cannot reject an examining or treating doctor’s opinion as
11 unsupported or inconsistent without providing an explanation supported by
12 substantial evidence.”).
13 The ALJ explained the departure from Dr. Abrahimi’s MRFC. In the
14 “analysis” portion of the ALJ’s RFC discussion, the ALJ wrote: “I limited
[Plaintiff] to simple and routine instructions with only occasional changes in a
15
routine work setting and using judgment to make simple decisions to account
16
for his symptoms including tangential thoughts, insomnia, and hallucinations
17
and paranoid delusions at times.” [AR 34.] After explaining the other
18
limitations provided, the ALJ wrote: “However, the medical evidence does not
19
support any further limitations.” [Id.] The ALJ then explained at length why
20
the ALJ found that the medical evidence did not support further limitations
21
(including reasons discussed in the section above regarding Plaintiff’s
22
subjective symptom testimony). [Id.] The ALJ’s explanation is supported by
23
substantial evidence in the medical record, which the ALJ cited in the
24
decision. [Id.] Accordingly, this explanation was sufficient for the ALJ to
25
depart from Dr. Abrahimi’s prior administrative finding that Plaintiff’s MRFC
26
was “1-2 step routines.” See Lambert v. Saul, 980 F.3d 1266, 1277 (9th Cir.
27
2020) (“Our cases do not require ALJs to perform a line-by-line exegesis of the
28
1 | claimant’s testimony, nor do they require ALJs to draft dissertations when
2 || denying benefits.”).
3 Finally, the three occupations at issue — “night cleaner,” “dishwasher,”
4 || and “furniture stripper” — all involve Level Two reasoning that are allowable
5 || under the relevant nonexertional limitation (“[H]e can handle occasional
6 | changes in a routine work setting and use judgment to make simple
7 || decisions”). See Zavalin, 778 F.3d at 847. Thus, this nonexertional limit in
8 || the RFC did not lead to later error at step five.
| IV. Order
For all the reasons stated above, the Court finds that the ALJ’s decision
does not show legal error and is supported by substantial evidence. It
therefore is affirmed. A separate judgment will issue.
13
14! Dated: August 27, 2025
15 AP abies Lona □
16 PATRICIA DONAHUE
UNITED STATES MAGISTRATE JUDGE
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