I. INTRODUCTION

18 Plaintiff Wanda L. S.1 (“Plaintiff”) challenges the Commissioner’s denial of 19 disability insurance benefits (“SSDI”). For the reasons stated below, the decision 20 of the Commissioner is AFFIRMED. 21

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II. BACKGROUND

23 On August 21, 2017, Plaintiff applied for SSDI alleging disability beginning 24 September 12, 2016. (AR 158-61.) Plaintiff’s application was denied on October 25 25, 2017, and upon reconsideration on February 1, 2018. (AR 85, 88.) On March 26 27 1 Partially redacted in compliance with Federal Rule of Civil Procedure 5.2(c)(2)(B) and the recommendation of the Committee on Court Administration and Case 28 Management of the Judicial Conference of the United States. 1 9, 2018, Plaintiff appealed the Commissioner’s decision and requested a hearing 2 before an Administrative Law Judge (“ALJ”). (AR 101-03.) On October 30, 2019, 3 Plaintiff appeared with counsel for an in-person hearing before the ALJ. (AR 27- 4 60.) 5 6 The December 3, 2019, Decision 7 On December 3, 2019, the ALJ rendered her first unfavorable decision. (AR 8 6-23.) At step one, the ALJ found Plaintiff had not engaged in substantial gainful 9 activity since September 12, 2016, the alleged onset date. (AR 11.) At step two, 10 the ALJ determined that Plaintiff had multiple severe impairments: degenerative 11 disc disease with radiculitis, borderline cardiomegaly, asthma, fibromyalgia, 12 obesity, history of lupus, somatic disorder, neurocognitive disorder, depression, and 13 anxiety. (Id.) At step three, the ALJ found that Plaintiff did not have an 14 impairment or combination of impairments that medically equal the severity of the 15 impairments listed in 20 CFR §§ 404.1520(d), 404.1525, and 404.1526. (AR 12.) 16 Before proceeding to step four, the ALJ assessed that Plaintiff had the residual 17 functional capacity (“RFC”) to perform medium work as defined in 20 CFR 18 § 404.1567(c) except Plaintiff could lift or carry fifty pounds occasionally and 19 twenty-five pounds frequently; she could stand or walk six hours in an eight-hour 20 workday; she could sit six hours in an eight-hour workday; she must avoid 21 concentrated exposure to wetness, humidity, dust, gases, and other pulmonary 22 irritants; she is limited to simple, routine tasks with no public contact and only 23 occasional contact with coworkers and supervisors in a low stress job, defined as 24 having only occasional decision-making duties and changes in the work setting. 25 (AR 15.) At step four, the ALJ concluded that Plaintiff was unable to perform any 26 past relevant work as an administrative assistant. (AR 21.) At step five, 27 considering Plaintiff’s age, education, work experience, and RFC, the ALJ found 28 there were a significant number of jobs in the national economy that Plaintiff could 1 perform. (AR 21-22) 2 On April 14, 2020, Plaintiff filed suit asking this Court to reverse and remand 3 the matter. See Wanda S.-N. v. Saul, No. 20-0772 (C.D. Cal. filed Apr. 14, 2020). 4 On February 11, 2021, the Court reversed and remanded the matter to the 5 Commissioner for failing to explain how Plaintiff’s ability to perform minimal 6 activities of daily living around her daytime sleep schedule shows her activities of 7 daily living were inconsistent with her testimony, or that she could perform 8 medium work eight hours per day and forty hours per week, and failing to address 9 how Plaintiff’s limited activities of daily living would transfer to a work place 10 setting. See id. 11 12 The May 26, 2022, Decision 13 Following the remand, the ALJ rendered its second unfavorable decision on 14 May 26, 2022. (AR 2187-2210.) 15 At step one, Plaintiff did not engage in substantial gainful activity starting 16 September 12, 2016, through her date last insured of March 31, 2022. (AR 2193.) 17 At step two, the ALJ determined that Plaintiff had the same severe impairments 18 plus two additional impairments: borderline cardiomegaly, asthma, depression, 19 fibromyalgia, obesity, history of lupus, anxiety, neurocognitive disorder, somatic 20 disorder, degenerative disc disease with radiculitis, obstructive sleep apnea, and 21 chronic bronchitis. (Id.) At step three, the ALJ found that Plaintiff did not have an 22 impairment or combination of impairments that medically equaled the severity of 23 one of the impairments listed in 20 CFR §§ 404.1520(d), 404.1525, and 404.1526. 24 (AR 2194.) With to RFC, the ALJ assessed that Plaintiff can perform medium 25 work except Plaintiff can lift and/or carry fifty pounds occasionally and twenty-five 26 pounds frequently; Plaintiff can stand or walk for six hours out of an eight-hour 27 workday; Plaintiff can sit for six hours out of an eight-hour workday; Plaintiff must 28 avoid concentrated exposure to wetness, humidity, dust, gases, and other pulmonary 1 irritants; Plaintiff is limited to simple tasks with no public contact and only 2 occasional contact with coworkers and supervisors; Plaintiff can have only 3 occasional decision-making duties and changes in the work setting. (AR 2196.) At 4 step four, the ALJ found that Plaintiff was unable to perform any past relevant 5 work. (AR 2207.) At step five, considering Plaintiff’s age, education, work 6 experience, and RFC, the ALJ concluded there were a significant number of jobs in 7 the national economy that Plaintiff could have performed through the date last 8 insured. (AR 2208-09.) 9 On August 4, 2022, Plaintiff filed the present suit, arguing the ALJ (1) did 10 not properly consider the relevant medical evidence of record in determining 11 Plaintiff’s RFC, and (2) did not properly consider Plaintiff’s subjective statements 12 of record and testimony under oath in determining Plaintiff’s RFC. (Dkt. No. 23, 13 Joint Stipulation, (“JS”), at 6.) 14 15 III. STANDARD OF REVIEW 16 Under 42 U.S.C. § 405(g), a district court may review the Commissioner’s 17 decision to deny benefits. A court must affirm an ALJ’s findings of fact if, when 18 applied against proper legal standards, they are supported by substantial evidence. 19 Mayes v. Massanari, 276 F.3d 453, 458-59 (9th Cir. 2001). “Substantial evidence 20 . . . is ‘more than a mere scintilla[,]’ . . . [which] means—and means only—‘such 21 relevant evidence as a reasonable mind might accept as adequate to support a 22 conclusion.’” Biestek v. Berryhill, 587 U.S. __, 139 S. Ct. 1148, 1154, 203 L. Ed. 23 2d 504 (2019) (citations omitted); Revels v. Berryhill, 874 F.3d 648, 654 (9th Cir. 24 2017). Substantial evidence is shown “by setting out a detailed and thorough 25 summary of the facts and conflicting clinical evidence, stating his interpretation 26 thereof, and making findings.” Reddick v. Chater, 157 F.3d 715, 725 (9th Cir. 27 1998) (citation omitted). “[T]he Commissioner’s decision cannot be affirmed 28 simply by isolating a specific quantum of supporting evidence. Rather, a court must 1 consider the record as a whole, weighing both evidence that supports and evidence 2 that detracts from the Secretary’s conclusion.” Aukland v. Massanari, 257 F.3d 3 1033, 1035 (9th Cir. 2001) (citations and internal quotation marks omitted). 4 “However, the ALJ ‘need not discuss all evidence presented’” to her, but “must 5 only explain why ‘significant probative evidence has been rejected.’” Hurn v. 6 Berryhill, No. 17-00884, 2018 WL 4026357, at *3 (W.D. Wash. Aug. 23, 2018) 7 (citing Vincent on Behalf of Vincent v. Heckler, 739 F.2d 1393, 1394-95 (9th Cir. 8 1984)). 9 “‘Where evidence is susceptible to more than one rational interpretation,’ the 10 ALJ’s decision should be upheld.” Ryan v. Comm’r of Soc. Sec., 528 F.3d 1194, 11 1198 (9th Cir. 2008) (citing Burch v. Barnhart, 400 F.3d 676, 679 (9th Cir. 2005)); 12 see Robbins v. Soc. Sec. Admin., 466 F.3d 880, 882 (9th Cir. 2006) (“If the 13 evidence can support either affirming or reversing the ALJ’s conclusion, we may 14 not substitute our judgment for that of the ALJ.”). The Court may review only “the 15 reasons provided by the ALJ in the disability determination and may not affirm the 16 ALJ on a ground upon which [s]he did not rely.” Orn v. Astrue, 495 F.3d 625, 630 17 (9th Cir. 2007) (citing Connett v. Barnhart, 340 F.3d 871, 874 (9th Cir. 2003)). 18 19 IV. DISCUSSION 20 The parties filed a Joint Stipulation on May 10, 2023. (Dkt. No. 23.) 21 Plaintiff contends that the ALJ did not properly consider: (1) relevant medical 22 evidence in assessing Plaintiff’s RFC; and (2) did not properly consider Plaintiff’s 23 subjective statements of record and testimony under oath in her assessment of the 24 RFC. (JS at 6.) The Commissioner opposes both claims. (Id. at 18-22; 27-32.) 25 26 a. Claim One -- Medical Evidence 27 Plaintiff contends the ALJ did not properly consider the relevant medical 28 evidence of record in assessing her RFC. (Id.) 1 In the Joint Stipulation, Plaintiff sets forth a 10-page summary of medical 2 notes and reports in support of her claim that the ALJ erred. (JS at 8-18.) The 3 summary of the medical record is not clearly tied to any argument other than the 4 general, conclusory assertion that the “medical evidence of record [with respect to 5 Plaintiff’s physical impairments] clearly reflects that Plaintiff has consistently 6 complained of pain and fatigue throughout the relevant period of time.” (Id. at 16.) 7 However, with respect to Plaintiff’s physical impairments, Plaintiff does assert that 8 the ALJ erred in assessing a medium residual functional capacity because that 9 finding is inconsistent with Plaintiff’s grip strength as noted in the record. (Id. at 10 16-17.) With respect to Plaintiff’s mental impairments, Plaintiff again generally, 11 and in a conclusory fashion, argues that the medical evidence consistently 12 documents anxiety and depression plus lack of energy, fatigue, psychomotor 13 retardation, and inability to complete normal daily activities. (Id. at 17.) However, 14 Plaintiff does point to one state agency consultative examiner’s finding that 15 Plaintiff has “marked limitations” in the ability to respond to usual work situations 16 and changes in the work setting. (Id.) Plaintiff contends that this marked limitation 17 is incompatible with an RFC of “only occasional decision making duties and 18 changes in the work setting.” (Id.) 19 20 1. Legal Standard 21 An ALJ cannot reject an examining or treating physician’s opinion as 22 unsupported or inconsistent without providing an explanation supported by 23 substantial evidence. Kitchen v. Kijakazi, 82 F.4th 732, 739 (9th Cir. 2023) (citing 24 Woods v. Kijakazi, 32 F.4th 785, 792 (9th Cir. 2022)). The ALJ considers several 25 factors in weighing a treating physician’s opinions and must explain specifically 26 how it considered the supportability and consistency factors. Id. at 739-40. 27 “Supportability concerns how ‘a medical source supports a medical opinion’ with 28 relevant evidence, while consistency concerns how ‘a medical opinion is consistent 1 with the evidence from other medical and nonmedical sources.” Id. (quoting 2 Woods, 32 F.4th at 791-92). 3 4 2. Physical Impairments 5 The Court concludes that the ALJ properly set forth supportability and 6 consistency factors in weighing the different medical opinions. With respect to 7 Plaintiff’s objection to the ALJ’s assessment of a restricted range of medium work 8 because of her grip strength as measured by Dr. Lim, the Court has reviewed the 9 record and finds no error. 10 Dr. Lim opined that Plaintiff is restricted to standing and/or walking for 11 about six hours in an eight-hour workday with appropriate breaks; she can sit for 12 six hours in an eight-hour day with appropriate breaks; she can lift and/or carry 50 13 pounds occasionally and 25 pounds frequently; and she has environmental 14 limitations from having asthma. (AR 378-82.) The Court’s review finds that the 15 ALJ appropriately considered the supportability and consistency factors in 16 evaluating Dr. Lim’s opinion – the ALJ analyzed Dr. Lim’s specific examination 17 findings and compared Plaintiff’s purported physical impairments to Dr. Lim’s 18 assessment of Plaintiff’s impairments. (AR 2206.) See Rosalio O. v. Kijakazi, No. 19 22-8679, 2023 WL 5180325, at *6-7 (C.D. Cal. Aug. 11, 2023) (ALJ’s evaluation 20 of persuasiveness of medical opinions was supported by and consistent with the 21 overall record). 22 Plaintiff contends that there is an internal inconsistency in Dr. Lim’s report 23 that the ALJ failed to resolve because Dr. Lim’s examination of Plaintiff found that 24 she had a grip strength of 20 pounds of force using the right hand, and 15 pounds of 25 force using the left hand (left-hand dominant). (JS at 9-10; see also AR 378, 382.) 26 But, as noted by the Commissioner, Plaintiff points to no authority in support of 27 this argument and there is nothing in the applicable regulation defining medium 28 work that sets forth a required grip strength. (JS at 19-20.) 1 2 3. Mental Impairments 3 Plaintiff contends that the state psychological consultative examiner Dr. 4 Starrett’s finding of marked limitations in the ability to respond to usual work 5 situations and changes in work setting does not equate with “only occasional 6 decision making duties and changes in the work setting.” (AR 2205; see also AR 7 1655; JS at 17.) 8 The ALJ found Dr. Richard Starrett’s opinion somewhat persuasive. The 9 ALJ noted that Dr. Starrett opined Plaintiff has a moderate limitation with respect 10 to the ability to understand, remember, make judgments, and carry out complex 11 work activities, maintain adequate attention and persistence and interact 12 appropriately with supervisors, coworkers, and peers; marked limitation with 13 respect to her ability to respond appropriately to usual work situations; and mild 14 limitation with respect to her ability to understand, remember, and carry out short 15 and simplistic work-related activities. (AR 2204-05.) 16 The ALJ found Dr. Starrett’s opinion not supported by the results of his 17 examination of Plaintiff. The ALJ explained that even though Plaintiff had marked 18 limitations in responding appropriately to usual work situations and changes in 19 work settings, she admitted to being able to handle changes in routine and being 20 able to perform “a wide array activities of daily living.” (AR 2207.) The ALJ also 21 explained that Plaintiff’s treatment records show coherent, relevant, and logical 22 thought processes, intact memory, and good insight. (Id.) 23 The ALJ also evaluated the consistency of Dr. Starrett’s opinion with other 24 medical evidence and noted certain inconsistencies, specifically that Plaintiff was 25 described as depressed with flat affect, but she was still pleasant and cooperative. 26 (AR 2206-07.) Plaintiff reported having mildly impaired memory and 27 concentration, but medical reports also indicated her thought was organized, 28 thought content was normal, and she possessed an average fund of knowledge. 1 (AR 2206.) The ALJ explained that this evidence led her to conclude Plaintiff is 2 capable of simple tasks that do not require contact with the public, only occasional 3 contact with coworkers and supervisors, and only occasional decision-making and 4 changes in work settings. (AR 2207). The ALJ did not err here. Schroeder v. 5 Colvin, No. 13-1633, 2015 WL 93395, at *8 (C.D. Cal. Jan. 7, 2015) (finding that 6 an ALJ gave specific and legitimate reasons for discounting a physician’s opinion 7 when the claimant’s “admitted capabilities and his testimony about his limitations 8 were inconsistent with [the physician’s] severe findings.”) 9 10 b. Claim Two – Subjective Testimony 11 Plaintiff contends the ALJ did not properly consider Plaintiff’s subjective 12 statements of record and testimony under oath in assessing her RFC. (JS at 6.) 13 There is a two-step process for evaluating a claimant’s testimony about the 14 severity and limiting effect of the claimant’s symptoms. Vasquez v. Astrue, 572 15 F.3d 586, 591 (9th Cir. 2009). “First, the ALJ must determine whether the claimant 16 has presented objective medical evidence of an underlying impairment ‘which 17 could reasonably be expected to produce the pain or other symptoms alleged.’” 18 Lingenfelter v. Astrue, 504 F.3d 1028, 1036 (9th Cir. 2007) (quoting Bunnell v. 19 Sullivan, 947 F.2d 341, 344 (9th Cir. 1991) (en banc)). Once satisfied, the ALJ 20 must examine the entire case record, which includes the claimant’s own testimony, 21 for evidence on the intensity, persistence, and limiting effects of claimant’s 22 symptoms. Id. at 1035. 23 The ALJ must also take care not to pick and choose only that evidence that 24 bolsters her findings. Holohan v. Massanari, 246 F.3d 1195, 1208 (9th Cir. 2001); 25 see Ghanim v. Colvin, 763 F.3d 1154, 1164 (9th Cir. 2014). If the ALJ discounts 26 the claimant’s testimony for lack of credibility, she must provide specific, clear, and 27 convincing reasons for doing so. Brown-Hunter v. Colvin, 806 F.3d 487, 488-89 28 (9th Cir. 2015). 1 2 1. Objective Medical Evidence of an Underlying Impairment 3 For the first step of the analysis, Plaintiff must present objective medical 4 evidence of an underlying impairment “‘which could reasonably be expected to 5 produce the pain or other symptoms alleged.’” Lingenfelter, 504 F.3d at 1036 6 (quoting Bunnell, 947 F.2d at 344). 7 Here, Plaintiff presented objective medical evidence of an underlying 8 impairment that could reasonably be expected to produce her alleged symptoms 9 because she has numerous medical diagnoses of hypertension, asthma, thyroid 10 gland disorders, and depressive, anxiety, and obsessive-compulsive disorders, (AR 11 67), the cumulative effect of which could reasonably cause “widespread pain” in 12 her body and difficulties sleeping, focusing, and concentrating, (AR 2222-23), 13 among other symptoms. 14 Finding step one satisfied, the Court proceeds to step two. Samuel Z., No. 15 8:20-1924, 2022 WL 4842936, at *3 (C.D. Cal. Sept. 30, 2023); Kimberli M. S. v. 16 Kijakazi, No. 21-1836, 2023 WL 2346330, at *10 (S.D. Cal. Mar. 3, 2023). 17 18 2. Plaintiff’s testimony 19 For the second step of the analysis, the ALJ must examine the entire case 20 record—including the claimant’s testimony—for evidence on the intensity, 21 persistence, and limiting effects of the claimant’s symptoms. In evaluating the 22 claimant’s credibility, a court may consider a multitude of factors, such as 23 inconsistencies between the claimant’s statements, objective medical evidence, 24 daily activities, work record, and statements from healthcare providers or third 25 parties about the nature, severity, and effect of the symptoms. Thomas v. Barnhart, 26 278 F.3d 947, 958-59 (9th Cir. 2002). However, a lack of objective medical 27 evidence substantiating the claimant’s statements about symptoms by itself is not 28 grounds for discrediting the claimant’s symptom testimony. Id. 1 The ALJ discounted Plaintiff’s subjective symptom testimony finding that 2 the “positive objective findings” contained in the treatment records are 3 “inconsistent with the severity of the symptoms” Plaintiff alleges. (AR 2198.) The 4 ALJ listed the medical findings that were inconsistent with Plaintiff’s symptom 5 testimony (see AR 2198-99), but did not stop there. The ALJ identified what the 6 ALJ perceived were inconsistencies between the medical record and Plaintiff’s 7 testimony about her current capabilities. (See AR 2199.) The ALJ’s decision also 8 detailed how Plaintiff’s reported activities of daily living and her level of 9 engagements in current matters (for example, selling items left to her by her 10 parents, involvement in church activities, voluminous correspondence with 11 treatment providers) were inconsistent with her allegations of excessive fatigue and 12 limited ability to focus and perform tasks. (AR 2198.) 13 The Court finds that the ALJ’s reasons for discounting Plaintiff’s testimony 14 were “specific, clear, and convincing” and supported by substantial evidence. 15 Smith Kijakazi, 14 F.4th 1108, 1112 (9th Cir. 2021); Darden v. Saul, 855 F. App’x 16 352, 355 (9th Cir. 2021) (ALJ’s finding that claimant’s testimony conflicted with 17 activities of daily living, was internally inconsistent, and conflicted with history of 18 conservative treatment were “specific, clear, and convincing reasons”); Burch v. 19 Barnhart, 400 F.3d 676, 680-81 (9th Cir. 2005) (ALJ permitted to consider 20 inconsistencies between activities of daily living and claimant’s pain testimony). 21 While the evidence of daily activities may lead to an interpretation more favorable 22 to Plaintiff and while the ALJ’s decision did not address how Plaintiff’s activities 23 of daily living would transfer to a work place, the Court cannot say that the ALJ’s 24 interpretation was irrational. It is well settled that the Court “must uphold the 25 ALJ’s decision where the evidence is susceptible to more than one rational 26 interpretation.” Magallanes v. Bowen, 881 F.2d 747, 750 (9th Cir. 1989); Ryan, 27 528 F.3d at 1198. 28 1 V. CONCLUSION 2 IT IS ORDERED that Judgment shall be entered AFFIRMING the decision 3 of the Commissioner denying her period of disability and SSDI. 4 IT IS FURTHER ORDERED that the Clerk of the Court serve copies of this 5 Order and the Judgment on counsel for both parties. 6 DATED: October 31, 2023 /s/ 7

ROZELLA A. OLIVER

8 UNITED STATES MAGISTRATE JUDGE

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NOTICE

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THIS DECISION IS NOT INTENDED FOR PUBLICATION IN WESTLAW,

12 LEXIS/NEXIS, OR ANY OTHER LEGAL DATABASE. 13 14 15 16 17 18 19 20 21 22 23 24 25 26 27 28