Savage

IN THE UNITED STATES DISTRICT COURT

FOR THE DISTRICT OF OREGON

KARLI S.,1 Case No. 6:24-cv-01161-SB

Plaintiff, OPINION AND ORDER

v.

COMMISSIONER, SOCIAL SECURITY

ADMINISTRATION,

Defendant.

BECKERMAN, U.S. Magistrate Judge.

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

(“Commissioner”) denial of her application for Supplemental Security Income (“SSI”) under

Title XVI of the Social Security Act. The Court has jurisdiction over this matter pursuant to 42

U.S.C. § 405(g), 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 because it is free of harmful legal error and supported by substantial evidence in the

record.

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

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 twenty-nine years old on February 1, 2021, the alleged disability onset

date.2 (Tr. 57.) In her application, Plaintiff alleged disability based on a panic disorder, post-

traumatic stress disorder (“PTSD”), memory loss, anxiety, gastroparesis, a heart attack, and

stroke. (Id.)

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

on October 3, 2023, Plaintiff requested a hearing before an Administrative Law Judge (“ALJ”).

(Id. at 64, 75, 99.) Plaintiff and a vocational expert (“VE”) appeared and testified at an

administrative hearing held before an ALJ on April 11, 2024. (Id. at 32-56.) On April 23, 2024,

the ALJ issued a written decision denying Plaintiff’s application. (Id. at 17-26.) On May 14,

2024, the Appeals Council denied Plaintiff’s request for review, making the ALJ’s written

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

of that decision.

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

2 “[T]he earliest an SSI claimant can obtain benefits is the month after which [s]he filed

h[er] application[.]” Schiller v. Colvin, No. 12-771-AA, 2013 WL 3874044, at *1 n.1 (D. Or.

July 23, 2013) (citation omitted).

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. 17-26.) At step one, the ALJ concluded that while Plaintiff had engaged in

substantial gainful activity since February 1, 2021, the alleged onset date, there was a twelve-

month period during which Plaintiff did not engage in substantial gainful activity. (Id. at 19.) At

step two, the ALJ found that Plaintiff suffers from the following severe, medically determinable

impairments: PTSD, major depressive disorder (severe without psychotic features), panic

disorder, and generalized anxiety disorder. (Id. at 20.) At step three, the ALJ determined that

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

20-21.)

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

perform light work, subject to these limitations: (1) Plaintiff can persist at simple, routine,

repetitive tasks, (2) Plaintiff can make simple work-related decisions, (3) Plaintiff can perform

work with few if any changes in the workplace, and no assembly line pace work, and (4) Plaintiff

can tolerate occasional interaction with coworkers and the general public. (Id. at 21-22.)

At step four, the ALJ found that Plaintiff could no longer perform her past relevant work

as a waitress. (Id. at 24.) At step five, the ALJ found that Plaintiff was not disabled because a

significant number of jobs existed in the national economy that she could perform, such as a

housekeeping cleaner, cleaner II, and wall cleaner. (Id. at 25-26.)

DISCUSSION

Plaintiff argues that the ALJ erred by (1) failing to provide specific, clear, and convincing

reasons to discount her subjective symptom testimony; and (2) improperly discounting the

medical opinions of Anne Harper, Ph.D. (“Dr. Harper”). (Pl.’s Opening Br. (“Pl.’s Br.”) at 2-14,

ECF No. 11.)

I. SUBJECTIVE SYMPTOM TESTIMONY

Plaintiff argues that the ALJ failed to provide specific, clear, and convincing reasons to

discount her symptom testimony about her mental health disorders. (Pl.’s Br. at 2-8.)

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. Plaintiff’s Testimony

Plaintiff testified at the hearing that she could not work on a regular, full-time basis

because of her panic disorder, anxiety, and memory and concentration issues. (Tr. 43-44.) She

explained that social situations and speaking with people had become progressively more

difficult, to the point where she has panic attacks while grocery shopping, she avoids school

functions for her children, she has a freeze response in social situations, and she has periods of

“crying spells” and shutting down. (Id. at 44.) She testified that she currently takes Sertraline,

Lorazepam, and a third medication for sleeping. (Id. at 39.) When asked about side effects, she

stated that her medications cause migraines and headaches. (Id.)

With respect to work experience, Plaintiff testified that she worked for DoorDash as a

delivery driver in 2021, and that she was currently providing twenty hours per week of childcare

for her sister’s children. (Id.) She also was working “under the table” as a housecleaner for a few

hours per week, but she stopped because the situation was not safe. (Id. at 42-43.)

When asked about her ability to do such activities as grocery shopping or attending

parent-teacher conferences at her children’s school, she stated that she avoids conferences if

possible, and that she places online grocery orders and then picks up the items. (Id. at 45.) She

further testified that she takes Lorazepam when she feels a panic attack building in response to

the above social situations. (Id.)

When asked about her typical day, Plaintiff testified that she has difficulties getting

dressed and ready for the day, getting organized, and running errands. (Id. at 45-46.) Plaintiff

stated that while she takes care of her three children, attends appointments, and does “things for

the house,” it takes her a long time. (Id. at 46.) She further testified that she cooks meals, but it is

difficult for her to remember recipes so a majority of the foods they eat are fruits, vegetables, and

prepared foods. (Id. at 46-47.)

Plaintiff explained that sometimes she will freeze, shut down, and be unable to speak

when she gets overwhelmed. (Id. at 48.) While this condition has no specific trigger, she stated

that it happens every time she has to talk with people or go out in public. (Id. at 50.) When this

occurs, she has to lie down or sit in the dark with her hands over her ears and eyes in order to

prevent a “full-blown panic attack.” (Id. at 50.)

When asked about her previous activity as a Door Dash delivery driver, Plaintiff testified

that she worked while she was pregnant and worked until the week before she was due. (Id. at

51-52.) She testified that while it was difficult going inside restaurants to pick up orders due to

her anxiety, she was able to do it because she did not have to deal with people and was only

required to “pick up and deliver.” (Id. at 52.) With respect to providing childcare for her sister,

she explained that she watches her sister’s two children, in addition to her three children, usually

from Friday to Sunday while her sister works. (Id. at 51; see also Tr, 39, estimating that she

watches “each child” for twenty hours per week).

C. The ALJ’s Evaluation of Plaintiff’s Testimony

The ALJ discounted Plaintiff’s symptom testimony based in part on inconsistencies

between the alleged severity of Plaintiff’s mental health disorders and her reported daily

activities. (Id. at 23.) The ALJ considered Plaintiff’s ability to care for her household with three

children, drive, attend to her personal care, prepare meals, perform household chores, grocery

shop, care for pets, handle her finances, engage in hobbies, work at substantial gainful activity,

and go to the gym. (Id., citing id. at 221, 242, 548, 902, 1064, 1090; see also id. at 1147, 1182,

1196, further reflecting that Plaintiff goes to church and the gym.) The ALJ highlighted that

Plaintiff worked as a Door Dash delivery driver after the alleged onset date, and engaged in

substantial gainful activity by caring for her sister’s children, for which she received

compensation from the Department of Human Services (“DHS”).3 (Id. at 19, citing id. at 548,

1064; see also id. at 40, Plaintiff testified that DHS paid her up to $1,600 per month for watching

her sister’s children.) The ALJ further noted that Plaintiff worked as a housekeeper for a few

hours per week, from October 2021 through November 2023. (Id.; see also id. at 42, Plaintiff

testified that she performed “under the table” housekeeping work for a few hours per week.)

In light of this record, the ALJ found that Plaintiff had only moderate difficulties in

interacting with others, noting that she reported no problems getting along with her family and

friends. (Id. at 20, citing id. at 225, 246.) The ALJ also cited several examples from Plaintiff’s

mental status examinations, reflecting that she presented as alert and oriented, with intact

memory, a sufficient fund of knowledge, goal-directed thought processes, intact thought content,

and a pleasant and cooperative demeanor with intact speech, language, a normal ability to

communicate, and normal behavior. (Id. at 20, citing several medical records; see also id. at 22-

23, noting that at Plaintiff’s psychological evaluations, she was alert and oriented, appropriately

dressed with good grooming and hygiene, and presented with an appropriate attitude and

behavior, despite describing her mood as depressed and anxious).

3 The ALJ noted that Plaintiff’s sister also received DHS benefits for watching Plaintiff’s

children up to half-time per week. (Tr. 19.)

D. Analysis

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

objective medical evidence of underlying impairments that might reasonably produce the

symptoms alleged. (See Tr. 22, the ALJ found that Plaintiff’s “medically determinable

impairments could reasonably be expected to cause the alleged symptoms”). The ALJ was

therefore required to provide clear and convincing reasons for discounting Plaintiff’s symptom

testimony. See Ghanim, 763 F.3d at 1163. The Court concludes that the ALJ met that standard

here.

Plaintiff argues that her ability to perform the cited daily activities is not inconsistent with

her symptom testimony that she isolated at home because of the severity of her mental disorders.

(Pl.’s Br. at 13-14.) Notably, Plaintiff does not directly address the ALJ’s evaluation of her

ability to work as a DoorDash driver, childcare provider, and house cleaner after her alleged

onset date. (See Pl.’s Br. at 13, arguing that the ALJ mischaracterized her testimony regarding

self-care and her ability to prepare meals or go out in public, but not directly addressing her work

activities). Plaintiff’s ability to work at these jobs during the relevant time period—especially as

a DoorDash driver which requires entering restaurants to pick up orders—was a clear and

convincing reason to discount her testimony about the severity of her mental health limitations,

including reports of panic attacks when she goes out in public.4 See Ford v. Saul, 950 F.3d 1141,

4 Substantial evidence in the record supported the ALJ’s findings about Plaintiff’s work

history. (See, e.g., Tr. 42, Plaintiff testified that she performed “under the table” house cleaning

work for a few hours per week; id. at 50-51, Plaintiff testified that she watches her sister’s two

young children from Friday night to Sunday night, along with her own three children; id. at 51-

52, Plaintiff testified that she worked for DoorDash, her employment ended only because she

gave birth, and the employment worked out because she only had to “pick up and deliver” and

“didn’t really have to deal with people”). The Commissioner highlights Plaintiff’s testimony that

she was performing twenty hours of childcare per week “for each child.” (Def.’s Br. at 11, citing

Tr. 37, ECF No. 14.) Although Plaintiff’s initial answer suggested that DHS may have been

1156 (9th Cir. 2020) (“An ALJ may consider any work activity, including part-time work, in

determining whether a claimant is disabled[.]” (citing Drouin v. Sullivan, 966 F.2d 1255, 1258

(9th Cir. 1992))); see also Nadon v. Bisignano, 145 F.4th 1133, 1136 (9th Cir. 2025) (“[T]he

ALJ did not err by considering [the plaintiff]’s work as a personal care attendant. An ALJ is

permitted to consider any work done by a claimant when evaluating a disability claim, regardless

of whether the work constitutes substantial gainful activity.” (first citing Ford, 950 F.3d at 1156;

and then citing 20 C.F.R. § 404.1571)); Resco v. O’Malley, No. 23-35177, 2024 WL 3177785, at

*2 (9th Cir. June 26, 2024) (holding that the plaintiff’s “contention that the ALJ improperly

discounted her symptom testimony is unavailing where “the ALJ explained that [the plaintiff]’s

symptom testimony was undermined by her performing non-sedentary, part-time work during the

relevant period, and by evidence that she could return to work” (citing Ford, 950 F.3d at 1156));

Scavone v. O’Malley, No. 23-35132, 2024 WL 1553695, at *2 (9th Cir. Apr. 10, 2024) (“The

ALJ also reasonably concluded that [the plaintiff]’s more extreme claims about his symptoms

and limitations are inconsistent with . . . [the plaintiff]’s ability to occasionally work part time.”

(citing, as relevant, Ford, 950 F.3d at 1156)); Henry O. v. Kijakazi, No. 4:20-cv-05141-MKD,

2022 WL 2902732, at *7 (E.D. Wash. May 3, 2022) (finding that “the ALJ reasonably concluded

that Plaintiff’s activities of daily living were inconsistent with his symptom claims” and

“supported by substantial evidence” where the plaintiff had “returned to working at a substantial

gainful activity level” during the relevant time period).

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paying her to watch her sister’s children for forty hours per week (twenty hours for each child),

the record before the Court reflects that when the ALJ sought clarification that Plaintiff was

providing twenty hours of childcare “total,” Plaintiff responded, “[y]es, I believe so.” (Tr. 39-

40.)

Nor did the ALJ err in discounting the severity of Plaintiff’s limitations on the ground

that she made frequent visits to her gym. (Tr. 20.) Although Plaintiff argues that she only visited

the gym’s massage and light therapy room, she testified that she checks in at the front desk,

which is inconsistent with her testimony of extreme social limitations. (See id. at 48-49, Plaintiff

testified that she regularly visits Planet Fitness and is required to check in her phone at the front

desk; see also id. at 907, Plaintiff reported during a psychological evaluation that she was

“[c]apable of attending to all activities of daily living on [her] own”). It was reasonable for the

ALJ to conclude that Plaintiff’s ability to visit Planet Fitness on a regular basis, along with her

other activities of daily living, undermined her claims of panic attacks in public places.

The Court finds that Plaintiff’s ability to work at three different jobs and go to the gym

were clear and convincing reasons, supported by substantial evidence, to discount her symptom

testimony, and therefore the ALJ did not err in evaluating her symptom testimony.

II. MEDICAL OPINION EVIDENCE

Plaintiff argues that substantial evidence does not support the ALJ’s explanation for

discounting the opinions of Dr. Harper, Plaintiff’s licensed professional counselor. (Pl.’s Br. at 2-

8.)

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.” 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.” 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, 102 F.4th 1102,

1106 (9th Cir. 2024) (first citing Woods v. Kijakazi, 32 F.4th 785, 791-92 (9th Cir. 2022); and

then citing 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

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

Harper’s opinions.

Dr. Harper had been serving as Plaintiff’s mental health provider since October 29, 2021,

visiting with Plaintiff weekly for almost two years. (Tr. 293, 913.) In her first medical opinion,

Dr. Harper stated that Plaintiff reportedly suffered from, among other things, intrusive thoughts,

constant feelings of flight or flight response, emotional dysregulation, flashbacks and

nightmares, broken sleep, frequent heightened anxiety, decreased interest in activities,

hypervigilance, and dissociation. (Id. at 293.) Dr. Harper further stated that Plaintiff’s ability to

work would be impacted by her symptoms, namely that she is triggered by certain settings,

sounds, and comments, as well as experiencing difficulty with her memory and dissociation

when under stress. (Id. at 294.)

In her second opinion, Dr. Harper reported that Plaintiff continued to suffer from her

earlier reported symptoms, and Plaintiff was not able to work as a result of experiencing daily

panic in stress inducing places, such as public spaces. (Id. at 914.) Dr. Harper also opined that

Plaintiff had marked and extreme limitations in her ability to understand, remember, and carry

out simple instructions, make simple work-related judgments, interact appropriately with

coworkers, supervisors, and the public, and respond appropriately to changes in a routine work

setting. (Id. at 916-17.) Dr. Harper based these proffered limitations on Plaintiff’s reports of

hypervigilance, dissociative symptoms, and severe panic and “freezing.” (Id. at 917.) It was Dr.

Harper’s opinion based on Plaintiff’s reports that she would need to miss four or more days of

work per month. (Id. at 919.)

The ALJ found Dr. Harper’s opinion “unpersuasive” because it was based “almost

entirely” on Plaintiff’s self-reports, as Dr. Harper acknowledged throughout her opinions, and

because Dr. Harper’s proffered limitations were inconsistent with Plaintiff’s longitudinal medical

records which were “almost entirely benign.” (Id. at 24.) Plaintiff argues that the ALJ improperly

discounted Dr. Harper’s opinions based on Plaintiff’s self-reports because mental health opinions

often rely on self-reports, and that the ALJ ignored non-benign findings in Plaintiff’s medical

records. (Pl.’s Br. at 4-7.)

First, it is well settled that “[a] physician’s opinion of disability premised to a large extent

upon the claimant’s own accounts of his symptoms and limitations may be disregarded where

those complaints have been properly discounted.” Morgan v. Comm’r of Soc. Sec. Admin., 169

F.3d 595, 602 (9th Cir. 1999) (simplified); see also Bray v. Comm’r of Social Sec. Admin., 554

F.3d 1219, 1228 (9th Cir. 2009) (“As the district court noted, however, the treating physician’s

prescribed work restrictions were based on [the plaintiff]’s subjective characterization of her

symptoms. As the ALJ determined that [the plaintiff]’s description of her limitations was not

entirely credible, it is reasonable to discount a physician’s prescription that was based on those

less than credible statements.”).

Plaintiff is correct that “the rule allowing an ALJ to reject opinions based on self-reports

does not apply in the same manner to opinions regarding mental illness.” Buck v. Berryhill, 869

F.3d 1040, 1049 (9th Cir. 2017). However, in Buck, as in many subsequent cases citing Buck, the

mental health evaluators also based their opinions on some objective measure, such as clinical

interviews or mental status evaluations. See, e.g., id. (“[The mental health evaluator]’s opinion

was based in part on [the claimant]’s self-report that he had trouble keeping a job. However, [the

evaluator] also conducted a clinical interview and a mental status evaluation. These are objective

measures and cannot be discounted as a ‘self-report.’”); see also Neri v. Comm’r of Soc. Sec., No.

1:21-cv-01235-SAB, 2022 WL 16856160, at *16 n.13 (E.D. Cal. Nov. 10, 2022) (“Buck . . . is

inapposite to the instant matter. In Buck, the Ninth Circuit held a court should not reject a

psychiatric opinion that is based in part on the patient’s self-report, as well as on the clinician’s

observations, and objective measures such as a clinical interview and mental status evaluation.

Here, by contrast, the ALJ not only rejected [the evaluator’s] opinion because it relied heavily

(rather than in part) upon Plaintiff’s and his sister’s allegations, but also because the opinion was

internally inconsistent as well as inconsistent with Plaintiff’s reported activities and the medical

record[.]”) (citations omitted); Mona Faye C. v. Comm’r of Soc. Sec., No. 121CV00140DCNREP,

2022 WL 16639331, at *6 n.4 (D. Idaho Aug. 22, 2022) (“[I]mportantly, Buck did not overturn

the well-settled rule that a physician’s opinion of disability premised to a large extent upon the

claimant’s own accounts of his symptoms and limitations may be disregarded where those

complaints have been properly discounted by the ALJ. Instead, Buck clarified that an ALJ errs

when she relies on a claimant’s discredited self-reports to reject the ‘objective measures’ of a

psychologist’s evaluation.” (simplified) (first citing Buck, 869 F.3d at 1049; and then citing

Morgan, 169 F.3d at 602)), report and recommendation adopted, 2022 WL 16635577 (D. Idaho

Nov. 2, 2022); Aniya R. v. Comm’r of Soc. Sec., No. C21-1159 TLF, 2022 WL 2541100, at *3

(W.D. Wash. June 2, 2022) (“[T]he ALJ did not err in giving little weight to [the examining

psychologist’s] assessed limitations to the extent they were based on Plaintiff’s properly

discounted [mental health] symptom allegations.”).

Here, Dr. Harper highlighted several times in her reports that her opinions were based on

Plaintiff’s subjective self-reports. (See, e.g., Tr. 293-94, 378-79, 542-43, 914, 917-18, Dr. Harper

prefaced every opinion with “client complains of,” “client reports,” “client describes,” or

“according to [Plaintiff]”). Where Dr. Harper based her opinions on Plaintiff’s self-reports and

not on objective measures, the Court finds that the ALJ’s discounting of the opinions on that

ground was not error.

Even if the ALJ erred in discounting Dr. Harper’s opinions because they were based on

Plaintiff’s self-reports, the ALJ also discounted Dr. Harper’s opinions because they were

unsupported by the longitudinal record. (Id. at 20-21.) The ALJ cited substantial evidence in the

record that Plaintiff presented at appointments with variable mood and affect but otherwise as

alert and oriented with intact memory, a sufficient fund of knowledge, goal-directed thought

processes, intact thought content, a pleasant and cooperative demeanor, intact speech, sufficient

language, a normal ability to communicate, normal behavior, intact attention and concentration,

fair to good insight and judgment, and a well-groomed and well-kept appearance with

appropriate dress. (Id. at 20-21, citing dozens of medical records).

For these reasons, the Court finds that the ALJ adequately addressed the supportability

and consistency of Dr. Harper’s opinions, and substantial evidence supported the ALJ’s

interpretation.5 See Stanton v. O’Malley, No. 23-35474, 2024 WL 4224622, at *1 (9th Cir. Sept.

18, 2024) (“An ALJ must assess the persuasiveness of the relevant medical opinions and explain

how she considered the supportability and consistency factors. As to all four physicians, the ALJ

sufficiently explained her analysis, and her conclusions are supported by substantial evidence in

the record.” (first citing 20 C.F.R. § 416.920c(a)-(b); and then citing Woods, 32 F.4th at 791-

92)); see also Dunning v. Colvin, No. 24-803, 2025 WL 262338, at *1 (9th Cir. Jan. 22, 2025)

(“The ALJ determines the persuasiveness of medical opinions. The most important factors when

evaluating persuasiveness of medical opinions are supportability and consistency. The ALJ

found that part of [the] opinion was not persuasive because certain opinions . . . were not

supported by objective evidence and were inconsistent with other evidence in the record. . . .

These determinations are supported by substantial evidence.” (citing 20 C.F.R. § 404.1520c(a)).

Although Plaintiff weighs the evidence differently, substantial evidence in the record

supports the ALJ’s interpretation and therefore the Court “must uphold” the ALJ’s opinion. See

Steirer v. Kijakazi, No. 22-16792, 2023 WL 6999450, at *1 (9th Cir. Oct. 24, 2023) (“The ALJ

did not err. The ALJ evaluated the consistency and supportability of the opinions by weighing

each against[, inter alia,] objective clinical findings[.] Based on the ALJ’s interpretation of the

evidence, she rejected the medical opinions . . . as extreme. Because the record supports her

interpretation, we must uphold the ALJ’s decision.” (simplified) (first citing 20 C.F.R. §

416.920c(a); then quoting Andrews v. Shalala, 53 F.3d 1035, 1039 (9th Cir. 1995); then citing

Ford, 950 F.3d at 1154-55; and then citing Garrison, 759 F.3d at 1012)); Ahearn v. Saul, 988

5 The Court also notes that although Dr. Harper included more extreme limitations in her

check-the-box form, her narrative opinions opined only that Plaintiff’s “ability to do work related

to physical or mental activities . . . in a work setting might be impacted by the impairment to her

functioning that client reports to constantly experience.” (Tr. 293-94, 378-79, 542-43) (emphasis

added).

F.3d 1111, 1115-16 (9th Cir. 2021) (‘When the evidence can rationally be interpreted in more

than one way, the court must uphold the [ALJ’s] decision.” (quoting Mayes v. Massanari, 276

F.3d 453, 459 (9th Cir. 2001))).

For these reasons, the Court finds that the ALJ did not commit harmful error in

evaluating Dr. Harper’s opinions.

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 28th day of October, 2025.

HON. STACIE F. BECKERMAN

United States Magistrate Judge

PAGE 18 —- OPINION AND ORDER