# McNurlin

> District Court, D. Oregon · May 6, 2026

URL: https://www.frixlaw.com/law-library/cases/11327956

## Case

- **Full name:** Michelle M. v. Commissioner of Social Security Administration
- **Court:** District Court, D. Oregon
- **Decided:** May 6, 2026
- **Opinion:** 100trialcourt
- **Cited by:** 0 later opinions in the Frix Law Library

## Citator (automated)

- No negative treatment found by the automated citator. That is not the same as a confirmation that the case is good law; read the citing cases.
- Full citator and citing cases: https://www.frixlaw.com/law-library/cases/11327956

## Opinion text

IN THE UNITED STATES DISTRICT COURT
FOR THE DISTRICT OF OREGON

MICHELLE M.1, Case No. 6:25-cv-00429-JR
Plaintiff, OPINION AND ORDER
v.
COMMISSIONER OF SOCIAL
SECURITY ADMINISTRATION,

Defendant.
RUSSO, Magistrate Judge:
Plaintiff Michelle M. brings this action for judicial review of the final decision of the
Commissioner of Social Security (“Commissioner”) denying her application for Disability
Insurance Benefits under the Social Security Act. The Commissioner’s decision is reversed and
remanded for further proceedings.

1 In the interest of privacy, this opinion uses only the first name and initial of the last name of the
non-governmental party or parties in this case. Where applicable, this opinion uses the same
designation for a non-governmental party’s immediate family member.
PROCEDURAL BACKGROUND
Born in 1977, plaintiff alleges disability beginning February 7, 2022,2 due to chronic
obstructive pulmonary disease (“COPD”), spine injuries, right hand pain, lung and rib pain, a
burning sensation in her legs and feet, and daily headaches. Tr. 603, 606, 653. Her claim was

denied initially and upon reconsideration. On February 22, 2024, a hearing was held before an
Administrative Law Judge (“ALJ”), wherein plaintiff was represented by counsel and testified, as
did a vocational expert (“VE”). Tr. 231-53. On March 27, 2024, the ALJ issued a decision finding
plaintiff not disabled. Tr. 211-23. After the Appeals Council denied her request for review, plaintiff
filed a complaint in this Court. Tr. 1-7.
THE ALJ’S FINDINGS
At step one of the five step sequential evaluation process, the ALJ found plaintiff had not
engaged in substantial gainful activity since the alleged onset date. Tr. 214. At step two, the ALJ
determined the following impairments were medically determinable and severe: “remote history
of spinal fusion surgery; low back pain; facet arthropathy; super morbid obesity (BMI 49-52); mild

thoracic degenerative disc disease; bilateral carpal tunnel syndrome status post release;
gastroesophageal reflux disease (“GERD”); [COPD]; asthma; migraines/headaches; and lower
extremity numbness.” Id. At step three, the ALJ found plaintiff’s impairments, either singly or in
combination, did not meet or equal the requirements of a listed impairment. Id.
Because she did not establish a presumptive disability at step three, the ALJ continued to
evaluate how plaintiff’s impairments affected her ability to work. The ALJ resolved that plaintiff
had the residual function capacity (“RFC”) to perform sedentary work except:

2 Plaintiff previously applied for, and was denied, Disability Insurance Benefits and
Supplemental Security Income on December 12, 2014. Tr. 311-23.
[She can] occasionally climb ramps and stairs and never climb ladders, ropes, or scaffolds.
[Plaintiff] can occasionally stoop, kneel, crouch, and crawl. [She] can occasionally reach
overhead with both upper extremities. [She] can frequently finger with both upper
extremities. [She] can tolerate no concentrated exposure to pulmonary irritants.

Tr. 217.
At step four, the ALJ determined plaintiff capable of performing her past relevant work as
a receptionist and policyholder information clerk. Tr. 221. At step five, the ALJ alternatively found
that plaintiff could perform jobs that existed in significant numbers in the national economy,
including the jobs of document preparer, surveillance system monitor, and paramutual ticket
checker. Tr. 222.
DISCUSSION
Plaintiff argues the ALJ erred by (1) finding the medical opinion of Deborah Reynolds,
NP, unpersuasive; (2) discounting plaintiff’s subjective symptom testimony by clear and
convincing reasons; and (3) by rejecting the lay witness testimony of her son. Pl.’s Opening Br. 2-
3 (doc. 11).
(1) Deborah Reynolds. Deborah Reynolds, a nurse practitioner, has been treating plaintiff
since August 2019. Tr. 1113. In her 2023 opinion, Reynolds diagnosed plaintiff with fusion of
spine, radiculopathy, spinal stenosis, intervertebral disc degeneration and displacement,
spondylosis without myelopathy or radiculopathy, scoliosis, paresthesia of skin, migraine without
aura (not intractable, without status migrainosus), chronic fatigue, major depressive disorder, and
insomnia. Id. Reynolds stated that plaintiff would have to lie down or rest for twenty minutes to
twenty-four hours a day to relieve her symptoms. Tr. 1114. She noted that plaintiff’s conditions
were multi-factorial and could be related to her mood disorder, daily headaches, recurrent
migraines, or her back pain which is relieved only with lying down. Id. Reynolds opined that
plaintiff could sit for thirty to sixty minutes at a time for a total of twelve hours per day but also
could stand or walk for ten minutes at a time, less than one hour total per day. Tr. 1110, 1114.
Plaintiff would need to take an unscheduled break every five to ten minutes in an eight-hour
workday. Tr. 1114. Reynolds also stated that plaintiff would need to periodically elevate her legs
in an eight-hour period. Tr. 1115. Lastly, Reynolds said plaintiff would be off-task at least twenty-

five percent of the workday and would be absent at least four workdays per month due to chronic
fatigue, depression, dizziness, upper extremity weakness, headaches, back pain, and numbness and
tingling in her legs. Id.
The ALJ found Reynolds’s opinion unpersuasive. Tr. 220. However, the ALJ failed to
evaluate the entirety of it. When looking to Reynolds’s opinion, the form provided by plaintiff’s
counsel appears to be a typical treating source statement with several questions and spaces for the
provider to handwrite their answers. See Tr. 1108-1112. However, Reynolds opted to provide typed
answers to the form’s questions, which were attached to the back of the form and directly
correspond to the original form’s questions. See Tr. 1113-15. In her decision, however, the ALJ
stated “Ms. Reynolds opined that [plaintiff] could walk [half] of a block without rest or significant

pain, and she could only sit for [sixty] minutes at a time and stand [or] walk [ten] minutes at a
time. However, none of the remaining questions on the form submitted by the representative were
answered, and no explanation was given for the limits given.” Tr. 220. Though the ALJ is correct
that Reynolds handwrote and circled a few of the questions on the original form, see Tr. 1110, she
also provided full explanations for each question later on in the opinion, having taken the time to
type them out. Compare Tr. 220 with Tr. 1113-15. For example, Reynolds answered question four
by stating “[t]he patient has a [prior medical history] of chronic pain that is multi-factorial in
etiology[]” and goes on to reference observations in the record pertaining to her “documented
cervical radiculopathy with bilateral upper extremity symptoms” and also mentions her treatment
for depression “since 1996 with multiple drug trials of SSRI and SNRI[]s.” Tr. 1113-14. But the
ALJ did not acknowledge that explanation or any other explanation provided by Reynolds. And
there is no way to know how the ALJ would weigh the supportability and consistency factors of
this opinion without a full explanation, as the Court can only review the reasons the ALJ asserts,

not the reasons the ALJ could have given. Connett v. Barnhart, 340 F.3d 871, 874 (9th Cir. 2003)
(“We are constrained to review the reasons the ALJ asserts.”); Pinto v. Massanari, 249 F.3d 840,
847-48 (9th Cir. 2001) (“[W]e cannot affirm the decision of any agency on a ground that the agency
did not invoke in making its decision.”). Thus, the ALJ’s assertion that Reynolds’s opinion was
“of little utility given the lack of specifics given,” is not supported by substantial evidence,
constitutes harmful error, and requires remand.
(2) Subjective Symptom Testimony. Plaintiff argues the ALJ failed to give specific, clear
and convincing reasons for discounting her subjective symptom testimony. Pl.’s Opening Br. 11-
18 (doc. 11); Brown-Hunter v. Colvin, 806 F.3d 487, 488-89 (9th Cir. 2015) (if a claimant provides
objective medical evidence of an underlying impairment and there is no affirmative evidence of

malingering, the ALJ must provide specific, clear and convincing reasons for discounting the
claimant’s testimony); 20 C.F.R. § 404.1529. According to plaintiff, the ALJ’s basis for
discounting her symptom testimony—inconsistency with the objective medical evidence and
conservative treatment—were unsupported or failed to account for the entire record. Pl.’s Opening
Br. 11-18 (doc. 11). The Court agrees, in part.
(a) Objective Medical Evidence. The ALJ acknowledged the record supported
plaintiff’s complaints regarding her back pain and carpal tunnel condition, but found that
neurosurgical intervention was deemed unnecessary, and that many of her examination findings
were normal. Tr. 218-19. The ALJ first discussed plaintiff’s musculoskeletal issues. The ALJ cited
plaintiff’s 2022 consultative examination where she exhibited normal gait, good hand-eye
coordination, no balance issues, and five-out-of-five muscle strength. Tr. 219, citing Tr. 1008-17.
During this same exam, however, the ALJ noted that plaintiff was unable to squat and rise with
ease, hop on one foot bilaterally, or walk on her heels and toes. Id. The ALJ next discussed

plaintiff’s 2023 spine specialist consultation, where she presented with a walker, but the ALJ stated
the “objective findings were not indicative of substantial limits.” Tr. 219, citing Tr. 1134. The ALJ
cited plaintiff’s “normal muscle tone and bulk [with five-out-of-five] strength throughout[,]” but
also cited her “bilateral paraspinal muscle tension around the lumbar spine” and that “[p]ercussion
of the spine produced pain at L5-SI[.]” Id., citing Tr. 1135-36. The ALJ then cited plaintiff’s
normal gait but also mentioned that her “back range of motion was full but did produce some
pain.” Id., citing Tr. 1136.
The ALJ failed to identify objective medical evidence that directly conflicted with
plaintiff’s testimony about limitations stemming from her chronic back pain and did not offer a
clear and convincing reason for discounting it. Conflict with objective medical evidence can be a

sufficient basis for discounting a claimant’s testimony. Smartt v. Kijakazi, 53 F.4th 489, 498 (9th
Cir. 2022); 20 C.F.R. § 416.929(c)(2). However, the records the ALJ cited establish that plaintiff
has a baseline of strength and flexibility. The records also support plaintiff’s testimony about the
amount and source of the back pain she suffers, but the ALJ seemingly ignores those observations
without explanation. See Tr. 1134-36. The bulk of plaintiff’s testimony described the difficulties
she suffers as a result of back pain, which does not conflict with gait or range of motion tests.
Because the evidence the ALJ cited did not conflict with plaintiff’s symptom testimony, this was
not a clear and convincing reason for the ALJ to discount plaintiff’s allegations.
In contrast, the ALJ provided sufficient evidence and reasoning to discount plaintiff’s
testimony regarding her asthma, COPD, and stomach issues. Regarding plaintiff’s respiratory
issues, the ALJ found that the objective medical evidence contrasted with her symptom testimony,
mainly because her exacerbation in symptoms were “often linked to infections, including COVID-

19 and pneumonia.” Tr. 219, citing Tr. 1043, 1090. Disability is defined as the “inability to engage
in any substantial gainful activity by reason of any medically determinable physical or mental
impairment which can be expected to result in death or which has lasted or can be expected to last
for a continuous period of not less than 12 months[.]” 42 U.S.C. §§ 423(d)(1)(A), (B); see also
Thompson v. City of Tualatin, No. 3:21-CV-01587-MO, 2022 WL 742682 (D. Or. Mar. 11, 2022)
(holding that because most COVID-19 cases last fewer than 20 days, merely being perceived as
having COVID-19 does not qualify as a disability). The ALJ also mentioned that plaintiff “had
trouble tolerating powder formulations for controllers” but that nevertheless her “spirometry
findings have been normal or indicated only mild obstruction.” Tr. 219, citing Tr. 1020-21, 1238,
1257. Plaintiff does not provide any arguments or evidence disputing the ALJ’s findings. See

Shinseki v. Sanders, 556 U.S. 396, 409-10, 129 S. Ct. 1696, 173 L. Ed. 2d 532 (2009) (the party
challenging the ALJ’s decision bears the burden of showing harm). Therefore, any challenge to
this finding is waived. See Carmickle v. Comm’r, Soc. Sec. Admin., 533 F.3d 1155, 1161 n.2 (9th
Cir. 2008).
The ALJ next discussed plaintiff’s gastrointestinal symptoms and acknowledged her recent
reports of “constant abdominal pain and nausea.” Tr. 219, citing Tr. 1278. But the ALJ contrasted
those complaints with plaintiff’s 2024 ultrasound, which showed hepatic steatosis with no acute
abnormality. Id., citing Tr. 1284. The ALJ also discussed plaintiff’s March 2022 evaluation where
she had been referred for gastroesophageal reflux disease. Id., citing Tr. 1001. But only lifestyle
changes were recommended. Id., citing Tr. 1003. Again, plaintiff does not provide any arguments
or evidence disputing the ALJ’s findings, and the ALJ’s reasoning is supported by substantial
evidence in the record. See Shinseki, 556 U.S. at 409-10; see also Carmickle, 533 F.3d at 1161 n.2.
Overall, the ALJ’s reliance on objective medical evidence was a sufficient basis to discount

plaintiff’s testimony regarding her asthma, COPD, and stomach issues. See Smartt, 53 F.4th at
498. Plaintiff does not contest either line of reasoning. See generally Pl.’s Opening Br. (doc. 11).
However, the same cannot be said about the ALJ’s findings regarding plaintiff’s testimony
regarding her chronic back pain. Because the evidence the ALJ cited did not conflict with
plaintiff’s symptom testimony regarding her chronic back pain, this was not a clear and convincing
reason for the ALJ to discount plaintiff’s allegations and must be addressed on remand.
(b) Conservative Treatment. The ALJ’s main reason for discounting plaintiff’s
symptom testimony was due to plaintiff’s conservative treatment and failure to seek treatment. See
Tr. 218-220. A claimant’s conservative course of treatment for an allegedly disabling condition
can undercut subjective testimony regarding the severity of the limitations that impairment causes.

Parra v. Astrue, 481 F.3d 742, 750-51 (9th Cir. 2007). Not seeking an “aggressive treatment
program” permits the inference that symptoms were not as all-disabling as the claimant reported.
Tommasetti v. Astrue, 533 F.3d 1035, 1039 (9th Cir. 2008). The amount of treatment is “an
important indicator of the intensity and persistence of [a claimant’s] symptoms.” 20 C.F.R. §
416.929(c)(3). If, however, the claimant has a good reason for not seeking more aggressive
treatment, conservative treatment is not a proper basis for rejecting the claimant’s subjective
symptoms. Carmickle, 533 F.3d at 1162.
The ALJ first highlighted plaintiff’s “limited and routine” treatment for back pain and
carpal tunnel, citing multiple instances where plaintiff demonstrated her disinterest and lack of
follow-up. Tr. 218. The ALJ cited physical therapy notes from 2020 where plaintiff attended eight
sessions of physical therapy before being discharged due to non-response to scheduling. Id., citing
Tr. 666-87, 1214. The ALJ then noted that plaintiff did not attempt additional physical therapy
sessions because “physical therapy has never worked.” Id., citing Tr. 826-39, 1133, 1263. The ALJ

also mentioned that acupuncture and massage have also been recommended to plaintiff, but she
was not interested. Id., citing Tr. 1214. The ALJ then acknowledged that plaintiff went to pain
specialists in 2021 and underwent epidural steroid injections, with little benefit. Id., citing Tr. 792-
825, 826-39. The ALJ summed up her evaluation by stating:
While [plaintiff] alleges being essentially bedbound, such extreme symptoms are markedly
inconsistent with her limited follow-up with treatment and examination findings that have
been largely normal. For example, she has alleged difficulty using her right hand, yet has
failed to pursue a carpal tunnel release on the right in over [ten] years and was able to use
both hands without any apparent issue during the consultative examination. She alleges
debilitating pain, yet was only taking over-the-counter medications by the time of the
consultative examination in late 2022, months after the amended alleged onset date. She
alleges significant headache symptoms, yet admitted during testimony to taking ibuprofen
for symptom relief.

Tr. 220 (internal citations omitted).3

Plaintiff argues the ALJ’s evaluation fails to account for plaintiff’s failed treatment
modalities and financial barriers to access. See Pl.’s Opening Br. 14-18 (doc. 11); see also Tr. 811-
12, 817, 832, 836, 838, 1059, 1263. Plaintiff indicated that at one point she did not have insurance
but was willing to pay out of pocket for her testing using money from her divorce. Tr. 1036.
Reynolds then referred plaintiff to neurology for nerve conduction studies but indicated that
diagnostic studies were still limited because plaintiff did not have insurance. Tr. 1271, 1040
(plaintiff’s symptoms were “likely coming from her neck” and noting, “[a]t this point [plaintiff]

3 The ALJ mischaracterized plaintiff’s statement at the administrative hearing here, as plaintiff
stated she takes ibuprofen and Vicodin for symptom relief, neither of which are helpful. See Tr.
241.
does not have health insurance, [so] physical therapy and [an] MRI is not much of an option.”).
Reynolds then tried plaintiff on Tizanidine, but it was not helpful. Tr. 1271, 1263. Plaintiff asserts
that once she was secured insurance, she had an MRI on back which showed abnormalities and
also had a nerve conduction study and EMG done on her wrist for carpal tunnel. Tr. 1259-60, 1287.

In 2024, plaintiff had a carpal tunnel release surgery performed on her dominant hand. Tr. 19-20.
Because the ALJ relied on conservative treatment as a main reason to undermine plaintiff’s
testimony but failed to consider her financial barriers to treatment and failed treatment modalities,
this aspect of plaintiff’s care needs to be reevaluated on remand alongside Reynolds’s full medical
opinion. For example, the ALJ stated that plaintiff “alleges debilitating pain, yet was only taking
over-the-counter medications by the time of the consultative examination in late 2022[,]” but also
acknowledges that in 2023 plaintiff began taking opiates for chronic pain. Compare Tr. 220 with
Tr. 218, citing Tr. 1233, 1273. And despite acknowledging that plaintiff was taking opiates for
chronic pain, the record shows that plaintiff tried numerous pain medications all with side effects
and limited benefit, which the ALJ failed to mention in her decision. See Tr. 1059, 820 (Gabapentin

caused dizziness, lightheadedness, and nausea), 817 (Lyrica caused swelling in plaintiff’s hands
and feet), 811-12 (Belbuca was ineffective and caused dizziness), 1079 (unable to tolerate
Topamax and Phentermine due to insomnia), 1263 (Tizanidine was unhelpful), 1220
(Hydrocodone was only temporarily helpful). The record also documents that plaintiff underwent
interlaminar epidural steroid injections and a peripheral nerve block for cluneal nerve entrapment
without benefit. Tr. 832, 836, 838. The ALJ failed to acknowledge that plaintiff treated her back
condition with steroidal injections, which are not considered typical “conservative” treatment. See,
e.g., Contreras v. Berryhill, No. 19-CV-00154-KAW, 2020 WL 619792, at *4 (N.D. Cal. Feb. 10,
2020) (noting that “[n]umerous courts have rejected the argument that trigger point injections are
‘conservative’”); see also Lapeirre-Gutt v. Astrue, 382 F. App’x 662, 664 (9th Cir. 2010)
(suggesting treatments such as occipital nerve blocks and trigger point injections do not constitute
conservative treatment). The ALJ also faults plaintiff for failing to pursue a carpal tunnel release
but failed to consider that she was unable to afford the testing and procedure without insurance.

See Tr. 220, 1036, 1040, 1271. This is a sufficient explanation for failure to follow treatment
advice, and it was error for the ALJ not to consider it. Gamble v. Chater, 68 F.3d 319, 321 (9th
Cir. 1995). Plaintiff’s supposed “limited” care for her back pain and “fail[ure] to pursue” a carpal
tunnel release were not clear and convincing reasons to reject plaintiff’s testimony about these
symptoms. Tr. 220. On remand, the ALJ must consider plaintiff’s full treatment history and her
justifications for failure to follow through with carpal tunnel release surgery.
(3) Lay Witness Testimony. Plaintiff’s son provided a third-party statement regarding
plaintiff’s physical health-related limitations that tracked plaintiff’s own allegations. See Tr. 663.
The ALJ stated “[w]hile carefully considered and generally consistent with [plaintiff]’s subjective
reports, such extreme limits opined are not reflected in the record. Exams do not show findings

indicative of such inactivity, such as muscle atrophy, and [plaintiff]’s limited follow-through with
treatment does not support pain at the level alleged.” Plaintiff argues the ALJ’s reasoning is not
supported by substantial evidence in the record. Pl.’s Opening Br. 19 (doc. 11). The Court agrees.
The ALJ did not rely on substantial evidence when disregarding plaintiff’s son’s testimony
and therefore erred. As discussed above, the ALJ failed to supply legally sufficient reasons for
rejecting plaintiff’s subjective complaints about her back pain and carpal tunnel, and these same
rationales do not support the decision to discount the lay witness testimony. The ALJ erred in
rejecting the lay testimony in this case. Garrison v. Colvin, 759 F.3d 995, 1020-23 (9th Cir. 2014).
(4) Remedy. Within the Court’s discretion under 42 U.S.C. § 405(g) is the “decision whether
to remand for further proceedings or for an award of benefits.” Holohan v. Massanari, 246 F.3d
1195, 1208 (9th Cir. 2001) (citation omitted). Plaintiff asks the Court to remand for an award of
benefits but fails to address all of the requirements. Pl.’s Opening Br. 19 (doc. 11). Because

plaintiff fails to meaningfully address the credit-as-true standard, it is unnecessary for this Court
to address whether those requirements are met. See Burrell v. Colvin, 775 F.3d 1133, 1141 (9th
Cir. 2014) (discussing credit-as-true standard). Instead, the Court concludes that a remand for
further proceedings would be useful because there are conflicts and ambiguities in the record that
must be resolved by the ALJ. See Treichler v. Comm’r of Soc. Sec. Admin., 775 F.3d 1090, 1099-
1100 (9th Cir. 2014).
As discussed herein, the ALJ committed harmful legal error in regard to Reynolds’s
medical opinion and plaintiff’s subjective symptom testimony surrounding her physical
impairments. Further proceedings would be useful because the record is ambiguous as to plaintiff’s
functional abilities. As such, further proceedings are required to resolve this case. See Treichler,

775 F.3d at 1099 (except in “rare circumstances,” the proper remedy upon a finding of harmful
error is to remand for further administrative proceedings). Therefore, upon remand, the ALJ must
review the entire record, including Reynolds’s full medical opinion, consider plaintiff’s barriers to
treatment and failed treatment, and opine as to her combined functional abilities and, if necessary,
reweigh the medical and other evidence of record, reformulate plaintiff’s RFC, and obtain
additional VE testimony.

CONCLUSION
For the reasons stated above, the Commissioner’s decision is REVERSED, and this case is
REMANDED for further proceedings.
IT IS SO ORDERED.
DATED this 6th day of May, 2026.

/s/ Jolie A. Russo
Jolie A. Russo
United States Magistrate Judge

---

Source: Frix Law Library, https://www.frixlaw.com/law-library/cases/11327956. Public record. Not legal advice.