1 2 3 4 5 6 7 8 UNITED STATES DISTRICT COURT 9 CENTRAL DISTRICT OF CALIFORNIA 10 GISELA O., ) Case No. ED CV 19-674-PJW ) 11 Plaintiff, ) ) MEMORANDUM OPINION AND ORDER 12 v. ) ) 13 ANDREW M. SAUL, )

COMMISSIONER OF THE )

14 SOCIAL SECURITY ADMINISTRATION, ) ) 15 Defendant. ) ) 16 17 I. 18 INTRODUCTION 19 Plaintiff appeals a decision by Defendant Social Security 20 Administration (“the Agency”), denying her application for Disability 21 Insurance Benefits (“DIB”). She claims that the Administrative Law 22 Judge (“ALJ”) erred when he rejected her testimony and ignored the 23 medical evidence in finding that she was not disabled. For the 24 reasons explained below, the ALJ’s decision is affirmed.1 25 26 27 28 1 Pursuant to Rule 25(d) of the Federal Rules of Civil Procedure, Andrew M. Saul, the current Commissioner of the Social Security Administration, is substituted in as Defendant. 1 II. 2 SUMMARY OF PROCEEDINGS 3 In March 2016, Plaintiff applied for DIB, alleging that she had 4 been disabled since November 2015, due to degenerative disc disease in 5 her lumbar spine, arthritis, and chronic kidney disease. 6 (Administrative Record (“AR”) 66-67, 172-177.) Her records later 7 reflected that she also suffered from depression, bipolar disorder, 8 carpal tunnel syndrome, urinary tract infections, and GERD. (AR 18.) 9 Her application was denied initially and on reconsideration and she 10 requested and was granted a hearing before an ALJ. (AR 88-92, 98-99, 11 100-104.) In March 2018, Plaintiff appeared with counsel and 12 testified at the hearing. (AR 41-58.) In June 2018, the ALJ issued a 13 decision finding that Plaintiff was not disabled. (AR 13-28.) 14 Plaintiff appealed to the Appeals Council, which denied review. (AR 15 1-3.) This action followed. 16 III. 17 ANALYSIS 18 A. Plaintiff’s Testimony 19 Plaintiff testified at the administrative hearing that she was 20 incapable of working due to depression and low back pain that radiated 21 into her left leg. She explained that, due to her impairments, she 22 rested in bed 70 to 75 percent of the day, was unable to sit for more 23 than 10 to 15 minutes, and was unable to stand or walk for more than 24 30 to 60 minutes. (AR 43, 45, 49.) 25 The ALJ rejected this testimony, finding: (1) Plaintiff’s 26 testimony was inconsistent with the medical evidence, (2) her 27 treatment had been conservative and effective, and (3) her ability to 28 travel to the Dominican Republic in 2017 undermined her claim that she 2 1 could sit for only 10 to 15 minutes at a time. (AR 21-26.) Plaintiff 2 contends that the ALJ erred in doing so. For the following reasons, 3 the Court concludes that the ALJ did not err. 4 Generally speaking, the reasons cited by the ALJ for questioning 5 Plaintiff’s testimony are valid reasons for doing so. See Rollins v. 6 Massanari, 261 F.3d 853, 857 (9th Cir. 2001) (noting ALJ can consider 7 objective medical evidence in evaluating claimant’s credibility); 8 Warre v. Comm’r of Soc. Sec. Admin., 439 F.3d 1001, 1006 (9th Cir. 9 2006) (“Impairments that can be controlled effectively with medication 10 are not disabling for purposes of determining eligibility for SSI 11 benefits.”) (citations omitted); Parra v. Astrue, 481 F.3d 742, 751 12 (9th Cir. 2007) (noting evidence of conservative treatment can 13 undermine a claimant’s testimony about the severity of an impairment); 14 Reddick v. Chater, 157 F.3d 715, 722 (9th Cir. 1998) (explaining a 15 claimant’s activities bear on credibility where the level of activity 16 is inconsistent with the claimed limitations). And these reasons are 17 largely supported by the record. 18 The ALJ discussed the medical evidence in detail and found that 19 it was inconsistent with Plaintiff’s claims of debilitating physical 20 and mental impairment. (AR 21-26.) Although the ALJ recognized that 21 Plaintiff suffered from depression and bipolar disorder, he found that 22 the medical records reflected an overall improvement in her condition, 23 as well as “unremarkable” and “mild-moderate” findings during mental 24 status examinations, which did not support her claims of disabling 25 mental health symptoms. (AR 23-26.) 26 In general, the record supports the ALJ’s findings. Although 27 Plaintiff was hospitalized for depression and suicidal ideation in 28 September 2016, she was discharged six days later after taking 3 1 medication that improved her condition. (AR 516-518, 542-543.) Since 2 then, the health care providers who conducted mental status 3 examinations on her regularly reported that her mood and behavior were 4 normal and appropriate, without any signs of distress. (AR 571, 634- 5 651, 680.) Though she sometimes experienced anxiety and fluctuations 6 in her depression, these symptoms improved with changes to her 7 medication. (AR 574-579, 634-651.) 8 In January 2018, two months before the administrative hearing, 9 her mood and affect were appropriate, her psychotropic medication 10 helped her feel better and sleep well, and her bipolar disorder was 11 stable. (AR 680.) And, despite testifying that her depression caused 12 her to rest for 70 to 75 percent of her day, Plaintiff never reported 13 this to her doctors. 14 The Court finds that the ALJ’s discounting of Plaintiff’s 15 allegations of pain in her low back and left leg is a closer call. 16 The ALJ noted “unremarkable” and “generally mild” findings in the 17 medical records, including no focal neurological deficits, normal 18 gait, full muscle strength, and no difficulties with movement observed 19 by doctors, which, he found, undermined her claims that she was 20 severely limited in her ability to stand, walk, and sit. (AR 22-25.) 21 The records do reflect a series of normal physical examinations of her 22 low back and lower left leg, despite her consistent diagnoses of 23 severe degenerative disc disease in the lumbar spine with moderate to 24 severe disc height loss and moderate to severe foraminal stenosis. 25 (AR 303-304, 312-313, 564, 589, 594, 611, 617-620, 623-624, 625-628.) 26 But the ALJ overlooked other medical records in 2016 and 2017 that 27 indicate that Plaintiff exhibited reduced muscle strength in her left 28 leg and tenderness and neurological deficits in her lumbar spine. (AR 4 1 303, 487, 611, 657.) The medical records also support Plaintiff’s 2 contention that she consistently complained of low back pain, 3 requiring rest. (Joint Stip. at 6; AR 285, 323, 345, 484.) 4 Similarly, the ALJ pointed to the lack of atrophy in Plaintiff’s 5 lumbar region and left leg as support for his finding that she was not 6 in as much pain as she claimed to be, since her muscle strength was 7 not significantly altered. (AR 25.) The ALJ did not cite to anywhere 8 in the medical records that discusses muscle atrophy, however, and, to 9 the extent that he was relying on Plaintiff’s own reported muscle 10 strength to find a lack of atrophy, the records are inconsistent. 11 Nevertheless, even though the medical records reflect that 12 Plaintiff’s low back pain may have been more serious than the ALJ 13 described, they do not support the limitations claimed by Plaintiff. 14 Significantly, her treating physicians did not opine that she had any 15 functional limitations, let alone the significant limitations she 16 alleged. And, as the ALJ noted, his findings regarding her medical 17 records were consistent with the opinions of the reviewing physicians, 18 who provided the only medical opinions regarding Plaintiff’s ability 19 to work. (AR 25.) After reviewing the medical records, these doctors 20 determined that she could perform light work with some occasional 21 postural restrictions, despite her impairments. (AR 66-74, 76-86.) 22 Thus, on the whole, there is substantial evidence to support the ALJ’s 23 view that the medical evidence did not support Plaintiff’s claims of 24 debilitating impairment. 25 The ALJ also discounted Plaintiff’s testimony because the 26 treatments for her low back pain, depression, and bipolar disorder 27 were conservative and effective. The record supports this finding for 28 Plaintiff’s depression and bipolar disorder. Following her 5 1 hospitalization in 2016, her treatment consisted solely of medication 2 and therapy, which she reported helped resolve any symptoms of anxiety 3 and depression. (AR 574-579, 634-651.) In January 2018, she reported 4 that her prescription psychotropic medication, Seroquel, had helped 5 her feel better, and it was noted that her bipolar disorder was 6 stable. (AR 680.) 7 As for her low back pain, the Court disagrees with the ALJ’s 8 characterization that her treatment was routine and conservative. In 9 addition to medication to manage her pain, Plaintiff underwent 10 repeated medial branch blocks, radial frequency ablations, and 11 epidural steroid injections in her lumbar spine. (AR 285-290, 306- 12 309, 484-488, 495-498, 509-510, 654, 660-664.) The Court does not 13 consider such treatment to be conservative or routine. Moreover, 14 Plaintiff’s treating physician recommended surgery for her lumbar 15 spine but Plaintiff’s insurer denied her request for the procedure. 16 (AR 628-630.) The ALJ interpreted this denial as evidence that she 17 did not need it. (AR 24; Joint Stip. at 21.) The Court rejects this 18 finding. The fact that her insurance company denied her request to 19 pay for the surgery does not, in the Court’s view, establish that the 20 doctor was wrong and the insurance company was right. 21 The ALJ’s finding that treatment controlled Plaintiff’s pain, 22 however, is generally supported by the record. She reported pain 23 relief, lasting from about two to six months, from the epidural 24 steroid injections. (AR 44, 656.) After radial frequency ablation in 25 April 2016, she told her doctor that she felt relief and her symptoms 26 were manageable. (AR 493.) Plaintiff further reported that her pain 27 medication alleviated her pain by 60 percent. (AR 43, 654.) In July 28 6 1 2017, she told her doctor that she was “doing well with no new 2 complaints or concerns.” (AR 610.) 3 Plaintiff argues that the ALJ’s functional capacity determination 4 failed to account for the side effects of her medications, which she 5 alleged caused dizziness and drowsiness. (Joint Stip. at 17.) This 6 argument is rejected. The ALJ considered her testimony about side 7 effects but found that it was undermined by the record, which showed 8 that she had never reported any side effects to her treating 9 physicians. (AR 24-25.) This finding is supported by the medical 10 record. 11 Finally, the ALJ found that, because Plaintiff was able to fly 12 from California to the Dominican Republic in December 2017, she was 13 able to sit for longer than 10 to 15 minutes, as she claimed at the 14 hearing. (AR 25.) The ALJ did not err in doing so. The fact that 15 Plaintiff took an approximately seven-hour flight to the Dominican 16 Republic calls into question her claim that she could only sit for 10 17 to 15 minutes at a time. Though a single trip is not enough to 18 establish she could sit for eight hours a day at work, the ALJ did not 19 err in taking it into account that she had taken the flight(s) when 20 assessing her testimony. 21 In the end, the Court concludes that there is substantial 22 evidence in the record to support the ALJ’s finding that Plaintiff’s 23 claims were exaggerated and it is affirmed. See Carmickle v. Comm'r, 24 Soc. Sec., 533 F.3d 1155, 1162-63 (9th Cir. 2008). 25 B. Objective Medical Evidence 26 Plaintiff argues that the ALJ failed to consider relevant medical 27 evidence in determining her residual functional capacity. (Joint 28 Stip. at 4-8.) As discussed above, the Court finds that the ALJ 7 1 properly considered the medical evidence. There is nothing in 2 Plaintiff’s medical records that establish that she cannot work or 3 that she needs additional accommodations beyond those found by the 4 ALJ. None of her doctors opined that she could not work. Indeed, the 5 only medical opinions that discuss Plaintiff’s ability to work are 6 from the reviewing physicians and they both found that she could work. 7 (AR 66-74, 76-86.) The ALJ gave great weight to these opinions and 8 modeled his functional capacity finding on them. (AR 20, 25.) In 9 considering Plaintiff’s mental health, the ALJ also gave partial 10 weight to an examining psychiatrist who determined that Plaintiff was 11 precluded from high production, assembly-line type work. (AR 26.) 12 Nothing in the medical evidence is inconsistent with the ALJ’s 13 residual functional capacity finding. Therefore, the ALJ decision 14 that Plaintiff had the residual functional capacity to perform light 15 work with some limitations will not be disturbed.2 16 17 18 19 20 21 2 Plaintiff contends that the ALJ improperly characterized her carpal tunnel syndrome as nonsevere and argues that, if she were to 22 resume working, she would experience symptoms. (Joint Stip. at 7.) 23 At the administrative hearing, however, counsel only raised Plaintiff’s carpal tunnel in passing and Plaintiff never brought it up 24 during her testimony. (AR 40, 41-58.) Thus, it appears that Plaintiff did not believe then that it was an obstacle to her working. 25 Nevertheless, as the ALJ noted, the medical evidence shows that her carpal tunnel condition was treated effectively and, as a result, she 26 rarely mentioned it to her physicians after 2016. (AR 19.) That is 27 probably why her treating physicians never recommended any limitations or opined that she was unable to work due to her carpal tunnel. (AR 28 506-508, 545-546.) 8 1 Iv. 2 CONCLUSION 3 For the reasons set forth above, the Agency’s decision is 4] affirmed and the case is dismissed with prejudice. 5 IT IS SO ORDERED. 6 DATED: May 15, 2020. ‘ ie ened

PATRICK J. WALSH

9 UNITED STATES MAGISTRATE JUDGE 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 25 26 27 28 |] 0:\PdW\ECF Ready\Memo Opinion and Order.wpd