1 2 3 4 5 6 7 8 UNITED STATES DISTRICT COURT 9 CENTRAL DISTRICT OF CALIFORNIA 10 AHMED DAWOOD AHMED E.S.,1 ) Case No. SACV 19-1210-JPR 11 ) Plaintiff, ) 12 ) MEMORANDUM DECISION AND ORDER v. ) 13 )

ANDREW M. SAUL, )

14 Commissioner of Social ) Security, ) 15 ) Defendant. ) 16 ___________________________ ) 17 18 I. PROCEEDINGS 19 Plaintiff seeks review of the Commissioner’s final decision 20 denying his application for Social Security Disability Insurance 21 Benefits (“DIB”). The matter is before the Court on the parties’ 22 Joint Stipulation, filed April 17, 2020, which the Court has 23 taken under submission without oral argument. For the reasons 24 stated below, the Commissioner’s decision is affirmed. 25 26 1 Plaintiff’s name is partially redacted in line with 27 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 1 II. BACKGROUND 2 Plaintiff was born in 1954. (Administrative Record (“AR”) 3 128.) He has a master’s degree and worked for approximately 22 4 years as a sales manager. (See AR 143, 162; see also AR 44.) He 5 applied for DIB on April 30, 2013, alleging that he had been 6 unable to work since February 6, 2010 (AR 128-29), because of 7 high blood pressure, diabetes, and “[s]tint [sic] in artery” (AR 8 142). After his claim was denied initially and on 9 reconsideration, he requested a hearing. (AR 82-83.) A hearing 10 was held on October 8, 2014, at which Plaintiff, who was 11 represented by counsel, testified (AR 26, 29-42), as did a 12 vocational expert (AR 42-44). In a written decision dated 13 December 2, 2014, the ALJ found him not disabled. (AR 19; see AR 14 14-19.) He requested review from the Appeals Council (AR 9), but 15 it denied his request (AR 1). 16 Plaintiff filed an appeal in this Court on May 20, 2016, 17 seeking review of the Commissioner’s final decision. (AR 412- 18 14.) On November 21, 2016, by stipulation of the parties, the 19 Court remanded the action for further administrative proceedings. 20 (AR 419-24.) On July 19, 2018, the ALJ conducted another 21 hearing, at which Plaintiff, who was again represented by 22 counsel, and a VE again testified. (AR 376, 379-90.) In a 23 written decision dated August 27, 2018, the ALJ again found 24 Plaintiff not disabled. (AR 369; see AR 361-69.) The Appeals 25 Council considered Plaintiff’s written objections to the ALJ’s 26 decision and found no reason to assume jurisdiction. (AR 352- 27 54.) This action followed. 28 2 1 III. STANDARD OF REVIEW 2 Under 42 U.S.C. § 405(g), a district court may review the 3 Commissioner’s decision to deny benefits. The ALJ’s findings and 4 decision should be upheld if they are free of legal error and 5 supported by substantial evidence based on the record as a whole. 6 See Richardson v. Perales, 402 U.S. 389, 401 (1971); Parra v. 7 Astrue, 481 F.3d 742, 746 (9th Cir. 2007). Substantial evidence 8 means such evidence as a reasonable person might accept as 9 adequate to support a conclusion. Richardson, 402 U.S. at 401; 10 Lingenfelter v. Astrue, 504 F.3d 1028, 1035 (9th Cir. 2007). It 11 is “more than a mere scintilla but less than a preponderance.” 12 Lingenfelter, 504 F.3d at 1035 (citing Robbins v. Soc. Sec. 13 Admin., 466 F.3d 880, 882 (9th Cir. 2006)). “[W]hatever the 14 meaning of ‘substantial’ in other contexts, the threshold for 15 such evidentiary sufficiency is not high.” Biestek v. Berryhill, 16 139 S. Ct. 1148, 1154 (2019). To determine whether substantial 17 evidence supports a finding, the reviewing court “must review the 18 administrative record as a whole, weighing both the evidence that 19 supports and the evidence that detracts from the Commissioner’s 20 conclusion.” Reddick v. Chater, 157 F.3d 715, 720 (9th Cir. 21 1998). “If the evidence can reasonably support either affirming 22 or reversing,” the reviewing court “may not substitute its 23 judgment” for the Commissioner’s. Id. at 720-21. 24 IV. THE EVALUATION OF DISABILITY 25 People are “disabled” for Social Security purposes if they 26 are unable to engage in any substantial gainful activity owing to 27 a physical or mental impairment that is expected to result in 28 death or has lasted, or is expected to last, for a continuous 3 1 period of at least 12 months. 42 U.S.C. § 423(d)(1)(A); Drouin v. 2 Sullivan, 966 F.2d 1255, 1257 (9th Cir. 1992). 3 A. The Five-Step Evaluation Process 4 The ALJ follows a five-step sequential evaluation process in 5 assessing whether a claimant is disabled. 20 C.F.R. 6 § 404.1520(a)(4); Lester v. Chater, 81 F.3d 821, 828 n.5 (9th 7 Cir. 1995) (as amended Apr. 9, 1996). In the first step, the 8 Commissioner must determine whether the claimant is currently 9 engaged in substantial gainful activity; if so, the claimant is 10 not disabled and the claim must be denied. § 404.1520(a)(4)(i). 11 If the claimant is not engaged in substantial gainful 12 activity, the second step requires the Commissioner to determine 13 whether the claimant has a “severe” impairment or combination of 14 impairments significantly limiting his ability to do basic work 15 activities; if not, a finding of not disabled is made and the 16 claim must be denied. § 404.1520(a)(4)(ii) & (c). 17 If the claimant has a “severe” impairment or combination of 18 impairments, the third step requires the Commissioner to 19 determine whether the impairment or combination of impairments 20 meets or equals an impairment in the Listing of Impairments 21 (“Listing”) set forth at 20 C.F.R. part 404, subpart P, appendix 22 1; if so, disability is conclusively presumed and benefits are 23 awarded. § 404.1520(a)(4)(iii) & (d). 24 If the claimant’s impairment or combination of impairments 25 does not meet or equal an impairment in the Listing, the fourth 26 step requires the Commissioner to determine whether the claimant 27 28 4 1 has sufficient residual functional capacity (“RFC”)2 to perform 2 his past work; if so, the claimant is not disabled and the claim 3 must be denied. § 404.1520(a)(4)(iv). The claimant has the 4 burden of proving he is unable to perform past relevant work. 5 Drouin, 966 F.2d at 1257. If the claimant meets that burden, a 6 prima facie case of disability is established. Id. 7 If that happens or if the claimant has no past relevant 8 work, the Commissioner then bears the burden of establishing that 9 the claimant is not disabled because he can perform other 10 substantial gainful work available in the national economy, the 11 fifth and final step of the sequential analysis. 12 §§ 404.1520(a)(4)(v), 404.1560(b). 13 B. The ALJ’s Application of the Five-Step Process 14 At step one, the ALJ found that Plaintiff had not engaged in 15 substantial gainful activity since February 6, 2010,3 the alleged 16 onset date. (AR 363.) His date last insured was June 30, 2017. 17 (Id.) At step two, the ALJ determined that he had severe 18 impairments of “obesity, diabetes mellitus, hypertension, 19 coronary artery disease status post stenting with history of 20 angina pectoris and mitral valve replacement, and right knee 21 tendonitis.” (Id.) At step three, she found that Plaintiff’s 22 23 2 RFC is what a claimant can do despite existing exertional 24 and nonexertional limitations. § 404.1545(a)(1); see Cooper v. Sullivan, 880 F.2d 1152, 1155 n.5 (9th Cir. 1989). The 25 Commissioner assesses the claimant’s RFC between steps three and 26 four. Laborin v. Berryhill, 867 F.3d 1151, 1153 (9th Cir. 2017) (citing § 416.920(a)(4)). 27 3 Plaintiff worked for part of 2015 and earned almost 28 $25,000. (AR 515, 520.) 5 1 impairments did not meet or equal a listing. (AR 364.) At step 2 four, she concluded that he had the RFC to perform a limited 3 range of sedentary work: 4 [He] can lift and/or carry 10 pounds frequently and 5 occasionally; can stand and/or walk for two hours out of 6 an eight-hour workday; can sit for six hours out of an 7 eight-hour workday; can occasionally climb stairs, but 8 cannot climb ladders, ropes or scaffolds; cannot work at 9 unprotected heights or around moving and dangerous 10 machinery; and can frequently stoop, bend, crouch, crawl, 11 and squat. 12 (Id.) He could perform his past relevant work as generally 13 performed in the national economy but not as actually performed. 14 (AR 367-68.) Accordingly, the ALJ found him not disabled. (AR 15 369.) 16 V. DISCUSSION4 17 Plaintiff contends that the ALJ “impermissibly rejected 18 [his] subjective symptom testimony.” (J. Stip. at 4.) For the 19 reasons discussed below, the ALJ did not err. 20 21 4 In Lucia v. SEC, 138 S. Ct. 2044, 2055 (2018), the Supreme 22 Court held that ALJs of the Securities and Exchange Commission are “Officers of the United States” and thus subject to the 23 Appointments Clause. To the extent Lucia applies to Social Security ALJs, Plaintiff has forfeited the issue by failing to 24 raise it during his administrative proceedings. (See AR 25-46, 222-23, 352-54, 376-92, 434-54, 505-07); Meanel v. Apfel, 172 25 F.3d 1111, 1115 (9th Cir. 1999) (as amended) (plaintiff forfeits 26 issues not raised before ALJ or Appeals Council); see also Kabani & Co. v. SEC, 733 F. App’x 918, 919 (9th Cir. 2018) (rejecting 27 Lucia challenge because plaintiff did not raise it during administrative proceedings), cert. denied, 139 S. Ct. 2013 28 (2019). 6 1 A. Applicable Law 2 An ALJ’s assessment of a claimant’s allegations concerning 3 the severity of his symptoms is entitled to “great weight.” 4 Weetman v. Sullivan, 877 F.2d 20, 22 (9th Cir. 1989) (as amended) 5 (citation omitted); Nyman v. Heckler, 779 F.2d 528, 531 (9th Cir. 6 1985) (as amended Feb. 24, 1986). “[T]he ALJ is not ‘required to 7 believe every allegation of disabling pain, or else disability 8 benefits would be available for the asking, a result plainly 9 contrary to 42 U.S.C. § 423(d)(5)(A).’” Molina v. Astrue, 674 10 F.3d 1104, 1112 (9th Cir. 2012) (quoting Fair v. Bowen, 885 F.2d 11 597, 603 (9th Cir. 1989)). 12 In evaluating a claimant’s subjective symptom testimony, the 13 ALJ engages in a two-step analysis. See Lingenfelter, 504 F.3d 14 at 1035-36; see also SSR 16-3p, 2016 WL 1119029, at *3 (Mar. 16, 15 2016). First, the ALJ must determine whether the claimant has 16 presented “objective medical evidence of an underlying impairment 17 [that] could reasonably be expected to produce the pain or other 18 symptoms alleged.” Lingenfelter, 504 F.3d at 1036 (citation 19 omitted). If such objective medical evidence exists, the ALJ may 20 not reject a claimant’s testimony “simply because there is no 21 showing that the impairment can reasonably produce the degree of 22 symptom alleged.” Id. (citation omitted & emphasis in original). 23 If the claimant meets the first test, the ALJ may discount 24 the claimant’s subjective symptom testimony only if he makes 25 specific findings that support the conclusion. See Berry v. 26 Astrue, 622 F.3d 1228, 1234 (9th Cir. 2010). Absent a finding or 27 affirmative evidence of malingering, the ALJ must provide a 28 “clear and convincing” reason for rejecting the claimant’s 7 1 testimony. Brown-Hunter v. Colvin, 806 F.3d 487, 493 (9th Cir. 2 2015) (as amended) (citing Lingenfelter, 504 F.3d at 1036); 3 Treichler v. Comm’r of Soc. Sec. Admin., 775 F.3d 1090, 1102 4 (9th Cir. 2014). The ALJ may consider, among other factors, 5 the claimant’s (1) reputation for truthfulness, prior 6 inconsistent statements, and other testimony that appears less 7 than candid; (2) unexplained or inadequately explained failure to 8 seek treatment or to follow a prescribed course of treatment; 9 (3) daily activities; (4) work record; and (5) physicians’ and 10 third parties’ testimony. See Rounds v. Comm’r Soc. Sec. Admin., 11 807 F.3d 996, 1006 (9th Cir. 2015) (as amended); Thomas v. 12 Barnhart, 278 F.3d 947, 958-59 (9th Cir. 2002). If the ALJ’s 13 evaluation of a plaintiff’s alleged symptoms is supported by 14 substantial evidence in the record, the reviewing court “may not 15 engage in second-guessing.” Thomas, 278 F.3d at 959 (citation 16 omitted). 17 In evaluating a claimant’s subjective symptoms, the ALJ 18 considers “all of the available evidence” in the record, 19 § 404.1529(c)(1), including the “objective medical evidence,” 20 § 404.1529(c)(2), and “other evidence” from medical sources, 21 § 404.1529(c)(3). Objective medical evidence is obtained through 22 “medically acceptable clinical and laboratory diagnostic 23 techniques.” § 404.1529(c)(2). “[O]ther evidence” is everything 24 else relevant to evaluating pain, including, for example, 25 “medical opinions about the individual’s symptoms and their 26 effects” and the “longitudinal record of any treatment and its 27 success or failure.” SSR 16-3p, 2016 WL 1119029, at *6; see 28 § 404.1529(c)(3). 8 1 Contradiction with the “objective medical evidence” is a 2 “specific and legitimate” basis for rejecting a claimant’s 3 subjective symptom testimony. Morgan v. Comm’r of Soc. Sec. 4 Admin., 169 F.3d 595, 600 (9th Cir. 1999); see § 404.1529(c)(2). 5 But it “cannot form the sole basis for discounting” it. Burch v. 6 Barnhart, 400 F.3d 676, 681 (9th Cir. 2005). 7 B. Applicable Background 8 1. Objective medical and other evidence 9 a. Heart-related issues 10 Plaintiff underwent a “cardiac catheterization”5 on May 9, 11 2008, following a “markedly abnormal stress test.” (AR 225.) 12 During the catheterization, lesions and “moderate to diffuse 13 plaquing” of Plaintiff’s “LAD”6 artery were discovered. (AR 14 226.) The artery was inflated with a balloon, and a stent was 15 deployed. (AR 225.) Plaintiff was diagnosed with “[m]ultivessel 16 coronary artery disease.” (AR 226.) 17 On September 4, 2009, Plaintiff underwent another stress 18 test and reported “no chest pain with exercise.” (AR 227.) 19 Although he exhibited an “abnormal” electrocardiogram response to 20 exercise, he had no clinical response and “[v]ery good” 21 functional capacity. (Id.) On November 12, 2009, he underwent a 22 23 5 Cardiac catheterization is an imaging procedure used to evaluate heart function. See Cardiac Catheterization, Cleveland 24 Clinic, https://my.clevelandclinic.org/health/diagnostics/ 16832-cardiac-catheterization (last visited May 27, 2020). 25 26 6 “LAD” refers to the left anterior descending artery, which supplies the front and bottom of the left ventricle and the front 27 of the septum. See Coronary Arteries, Cleveland Clinic, https://my.clevelandclinic.org/health/articles/ 28 17063-coronary-arteries (last visited May 27, 2020). 9 1 “[l]eft heart catheterization.” (AR 262-63.) During the 2 procedure, “significant diffuse” coronary artery disease was 3 noted, involving a “very small nondominant right” coronary 4 artery, which was “extensively diseased,” and a “large dominant 5 left circumflex” artery, which had “disease in an obtuse marginal 6 artery and [a] posterior descending artery.” (AR 262-63.) 7 Progress notes from 2008 and 2009, both before and after 8 Plaintiff’s stent placement, indicate that although he reported 9 some chest pain, he had no significant functional difficulties, 10 and his symptoms generally improved. For instance, on February 11 14, 2008, he reported feeling “well,” with no chest pain, 12 shortness of breath, palpitations, dizziness, syncope, or leg 13 edema. (AR 238.) On May 5, 2008, he again was “well,” with 14 “[n]o effort intolerance” or any other symptoms. (AR 235.) On 15 June 19, 2008, he reported feeling “well,” with an “[e]ffort 16 tolerance of walking [two] miles” and no symptoms. (AR 241.) On 17 November 13, 2008, he also said he felt “well,” with no symptoms. 18 (AR 244.) On February 26, 2009, he again reported feeling 19 “well,” with an “[e]ffort tolerance of walking two to three 20 blocks” and no symptoms. (AR 247.) On May 28, 2009, he noted 21 “chest pain episodes while swimming,” but he described them as 22 “brief” and reported no other symptoms. (AR 250.) On October 6, 23 2009, he said he was “feel[ing] better,” with an “[e]ffort 24 tolerance of walking several blocks” and no recent symptoms. (AR 25 253.) 26 27 28 10 1 On June 9, 2011,7 more than a year after his alleged onset 2 date, Plaintiff saw cardiologist Richard Deits for a 3 consultation. (AR 350-51.) He indicated that he had had “no 4 further angina” since his stent placement in May 2008 and that he 5 could “play sports” and “remain very active” without chest pain 6 or shortness of breath. (AR 350.) Dr. Deits saw “no reason to 7 do a stress test,” noting that Plaintiff was “very active and has 8 no symptoms.” (AR 351.) At a September 8, 2011 follow-up visit, 9 Plaintiff related that he had been experiencing “increasing 10 fatigue[,] especially with exertion.” (AR 348.) He denied any 11 chest pain or shortness of breath, however, and admitted that he 12 was not taking his blood pressure medications routinely. (Id.) 13 Dr. Deits noted that “[m]ore than likely [Plaintiff’s] fatigue, 14 especially with exertion[,] is related to his hypertension” and 15 “discussed this” and “the need to be compliant with his 16 medications” with Plaintiff. (Id.) He noted that he was “very 17 active” and saw “no reason to do a stress test at this point in 18 time.” (Id.) On December 29, 2011, Plaintiff reported that he 19 had “[l]ess fatigue.” (AR 344.) He said that he had “DOE”8 and 20 that although he “used to play tennis for hours, now he [could] 21 22 7 The AR contains no medical records from the February 2010 23 alleged onset date to June 2011. Although Plaintiff stopped working on the alleged onset date, he indicated in his initial 24 Disability Report that he did so “[b]ecause of other reasons,” namely, his “[p]osition was terminated.” (AR 142.) 25 26 8 “DOE” stands for “dyspnea on exertion.” Medical Abbreviation List By Abbreviation, N.D. State Gov’t, http:// 27 www.ndhealth.gov/familyplanning/image/cache/ medical_terms_in_order_by_abbreviation.pdf (last visited May 27, 28 2020). 11 1 only last 30-45 minutes.” (Id.) Dr. Deits noted that his blood 2 pressure was “elevated” and that “[m]ore than likely his fatigue, 3 especially with exertion, is related to his hypertension.” (Id.) 4 At a January 12, 2012 follow-up visit, Plaintiff had lost 5 two pounds, but his blood pressure “remain[ed] up.” (AR 342.) 6 Dr. Deits noted that he “did not do as instructed” by beginning 7 his new blood-pressure medication and instead continued with his 8 previous medication. (Id.) Plaintiff reported on January 26, 9 2012, that he had started “tak[ing] his medications correctly” 10 and “fe[lt] better” with the new blood-pressure medication. (AR 11 340.) Dr. Deits noted that his blood pressure was “much better” 12 and that his coronary artery disease was “[s]table.” (Id.) 13 During an April 26, 2012 follow-up visit, Plaintiff said he had 14 traveled to Dubai and had had “no problems.” (AR 338.) He 15 denied any chest pain, shortness of breath, DOE, “orthopnea,”9 16 “PND” (paroxysmal nocturnal dyspnea),10 edema, dizziness, 17 lightheadedness, palpitations, or syncope. (Id.) On July 26, 18 2012, Plaintiff again denied those symptoms. (AR 336.) On 19 December 6, 2012, he reported that he had traveled to Egypt and 20 had “had no problems.” (AR 334.) He denied any symptoms. (Id.) 21 On May 2, 2013, he said his blood-pressure readings had been 22 “normal” and denied any symptoms. (AR 332.) Dr. Deits wrote him 23 a letter stating that he “may work in any field without 24 9 Orthopnea is discomfort in breathing brought on or 25 aggravated by lying flat. Stedman’s Medical Dictionary 1277-78 26 (27th ed. 2000). 27 10 Paroxysmal nocturnal dyspnea is shortness of breath “appearing suddenly at night, usually waking the patient from 28 sleep.” Stedman’s Medical Dictionary 556 (27th ed. 2000). 12 1 restrictions.” (AR 331.) On November 7, 2013, Plaintiff brought 2 his blood-pressure readings, which were “normal,” to a follow-up 3 visit. (AR 329.) He denied any symptoms. (Id.) 4 On July 14, 2014, he told Dr. Diets that he had “just 5 returned from Egypt.” (AR 327.) He denied any chest pain, 6 shortness of breath, DOE, orthopnea, PND, edema, dizziness, 7 lightheadedness, palpitations, or syncope. (Id.) 8 On January 12, 2015, Plaintiff underwent an echocardiogram, 9 with normal findings, including “[n]ormal left ventricular size 10 and function” and “[n]o evidence of significant valvular 11 dysfunction.” (AR 719.) On November 24, 2015, he underwent 12 another echocardiogram, which demonstrated that his left 13 ventricle “[s]ize [was] normal,” with “septal wall dyskinesis,” 14 “mild concentric left ventricular hypertrophy,” and “no diastolic 15 dysfunction.” (AR 709.) The aortic valve showed “no evidence of 16 stenosis but there [was] mild regurgitation.” (Id.) All other 17 findings were normal. (AR 709-10.) 18 Meanwhile, on January 22, 2015, Plaintiff reported at a 19 cardiology follow-up visit that he “got a job” and denied chest 20 pain, shortness of breath, DOE, orthopnea, PND, edema, dizziness, 21 lightheadedness, palpitations, or syncope. (AR 717.) Dr. Deits 22 noted that his echocardiogram was within normal limits. (AR 23 718.) At a June 4, 2015 follow-up visit, Plaintiff had “not lost 24 weight,” and his blood pressure “remained elevated.” (AR 715.) 25 But he denied any symptoms. (Id.) Notes from August 31, 2015, 26 indicate that Dr. Deits reviewed Plaintiff’s laboratory results, 27 was “concerned” about several of them, and would “add a [s]tatin” 28 to his prescription medications. (AR 713.) But Plaintiff again 13 1 denied any symptoms. (Id.) On November 16, 2015, Plaintiff 2 indicated that “[a]bout 10 days” before the appointment, “while 3 in bed he suddenly lost vision” and fainted. (AR 711.) His wife 4 “struck his chest” until he regained consciousness. (Id.) He 5 then “took a shower and drove himself to [the hospital],” where 6 he had coronary artery bypass graft surgery. (Id.) He stated 7 that he had “soreness from the CABG,” but he otherwise denied 8 chest pain, shortness of breath, DOE, orthopnea, PND, edema, 9 dizziness, lightheadedness, palpitations, or syncope. (Id.) The 10 postsurgery electrocardiogram indicated “[s]inus [r]hythm” and 11 “[n]on-specific T waves anterolaterally.” (AR 712.) On November 12 30, 2015, Plaintiff “continue[d] to have wound pain” but 13 otherwise denied any symptoms. (AR 707.) Dr. Deits noted that 14 the echocardiogram indicated “[s]eptal dyskinesia.”11 (AR 708.) 15 Notes from a December 21, 2015 follow-up visit state that 16 Plaintiff was “doing well” and denied any symptoms. (AR 699.) 17 Dr. Deits noted that he would discontinue one of Plaintiff’s 18 medications because he was “not having anymore [sic] chest pain.” 19 (AR 700.) 20 Progress notes from a May 23, 2016 follow-up visit state 21 that Plaintiff was “requesting an extension of his disability.” 22 (AR 701.) He said he did not “exercise as much” and got 23 “fatigued with exertion,” but he denied chest pain, shortness of 24 breath, DOE, orthopnea, PND, edema, dizziness, lightheadedness, 25 26 11 Dyskinesia is difficulty in performing voluntary 27 movements. Stedman’s Medical Dictionary 553 (27th ed. 2000). A septum is a thin wall dividing two cavities or masses of softer 28 tissue. Id. at 1620. 14 1 palpitations, or syncope. (Id.) Dr. Deits noted that he was 2 “stable from a cardiac” point of view, “advised him to 3 progressively increase his exercise,” and opined that he was not 4 “disabled from a cardiac POV.” (AR 702.) 5 Cardiology progress notes dated August 22, 2017, and March 6 1, 2018, indicated normal findings on physical examination and 7 that Plaintiff was “doing well,” denying any chest pain, 8 shortness of breath, orthopnea, dizziness, syncope, palpitations, 9 or lower extremity edema. (AR 764, 766.) Other than his 10 elevated blood-pressure readings and weight, Dr. Deits had noted 11 generally normal findings during each examination. (See AR 327, 12 329, 332, 334, 336, 338, 340, 342, 344, 346, 348, 350, 699, 701, 13 703, 705, 707, 711-12, 713, 715, 717.) 14 b. Diabetes and other issues 15 On September 20, 2012, Plaintiff saw Dr. Daniel Uribe,12 who 16 diagnosed him with type two diabetes and hypertension. (AR 275.) 17 At an October 5, 2012 follow-up visit to obtain lab results, Dr. 18 Uribe noted “[h]igh A1C”13 and a fasting blood sugar of “240,” 19 and he observed that Plaintiff “had been off meds.” (AR 274.) 20 Dr. Uribe noted at a May 30, 2013 follow-up visit to refill 21 medication that Plaintiff’s weight was down 11 pounds and that 22 his blood pressure was “118/66.” (AR 273.) During a June 19, 23 2013 visit, Dr. Uribe recorded Plaintiff’s blood pressure as 24 25 12 Dr. Uribe’s medical specialty is not apparent from the 26 record. 27 13 A1C is a blood test for type 2 diabetes and prediabetes. See A1C, MedlinePlus, https://medlineplus.gov/a1c.html (last 28 visited May 27, 2020). 15 1 “120/80” but indicated that he was “not following ‘good’ DM 2 diet.” (AR 272.) Plaintiff saw Dr. Uribe again on July 3, 2013, 3 to check a skin problem with his right leg. (AR 269.) 4 On August 23, 2016, Plaintiff attended a nephrology 5 consultation with Dr. Herbert S. Tiquia. (AR 746-47.) He 6 reported a “history of coronary artery disease, “MI,”14 and 7 “five-vessel coronary bypass surgery in November 2015.” (AR 8 746.) Dr. Tiquia noted that laboratory studies indicated an 9 “[e]levated serum creatinine” level that was “consistent with 10 likely stage 3 chronic kidney disease due to hypertensive 11 nephrosclerosis.” (AR 747.) But his urinalysis findings were 12 “fairly benign.” (Id.) Dr. Tiquia did “not suspect any 13 secondary systemic disorders such as autoimmune disease or 14 systemic vasculitis” and noted that Plaintiff’s diabetes was 15 under “fair control.” (Id.) Dr. Tiquia “had a lengthy 16 discussion with [Plaintiff] regarding the importance of sodium- 17 restricted diabetic diet” “to maintain maximal renal 18 preservation.” (Id.) 19 During an April 20, 2017 office visit with osteopath Mark 20 Varallo,15 Plaintiff complained of “right knee pain after 21 22 14 “MI” is an acronym for “myocardial infarction.” Medical 23 Abbreviation List By Abbreviation, N.D. State Gov’t, http://www.ndhealth.gov/familyplanning/image/cache/ 24 medical_terms_in_order_by_abbreviation.pdf (last visited May 27, 2020). 25 26 15 Dr. Varallo primarily practices family medicine. See Cal. Dep’t Consumer Aff. License Search, https:// 27 search.dca.ca.gov (search for “Varallo” under “License Type,” “Osteopathic Physician’s and Surgeon’s”) (last visited May 27, 28 2020). 16 1 carrying a heavy load eight weeks” before the office visit. (AR 2 609.) He described the pain as “aching.” (Id.) Dr. Varallo 3 noted on examination that Plaintiff’s right knee was “painful 4 medially,” but he had a “[n]egative Appleys [sic]” test16 and “no 5 effusion.” (AR 610.) Dr. Varallo “referred [Plaintiff] to 6 orthopedics” and ordered X-ray imaging of his right knee. (Id.) 7 The X-ray findings were normal, revealing “no evidence of 8 fracture,” “joint effusion,” or “focal bony lesion,” and “[b]one 9 mineral density [was] normal.” (AR 662.) 10 On July 25, 2017, after Plaintiff’s date last insured, he 11 saw Dr. Varallo to discuss test results. (AR 791.) He noted 12 that Plaintiff’s “right knee [was] painful at the insertion of 13 the sartorius,”17 but he indicated otherwise normal examination 14 findings. (AR 792.) Dr. Varallo’s assessment was “[d]iabetes 15 mellitus with renal manifestations, uncontrolled.” (Id.) He 16 indicated that Plaintiff should eat a “diet low in simple 17 carbohydrates” and engage in “30 minutes of exercise daily.” 18 (Id.) He said Plaintiff would be “switched to insulin” if his 19 diabetes was not under control at the next visit. (Id.) 20 Progress notes from September 17, 2017 indicate that Dr. Varallo 21 again encouraged Plaintiff to follow his diet and engage in “30 22 [minutes of] walking at least [three or four times] per week.” 23 (AR 790.) He noted again on October 24, 2017, that Plaintiff’s 24 16 An Apley’s test is used to evaluate patients for tears in 25 the meniscus of the knee. See Apley’s Test, Physiopedia, 26 https://www.physio-pedia.com/Apley%27s_Test (last visited May 27, 2020). 27 17 The sartorius is a superficial anterior thigh muscle. 28 Stedman’s Medical Dictionary 1154 (27th ed. 2000). 17 1 diabetes was “uncontrolled,” again prescribed a “[d]iet low in 2 simple carbohydrates,” and indicated that he would “be switched 3 to insulin” if his diabetes was not under control at the next 4 visit. (AR 786.) On November 2, 2017, Plaintiff complained of 5 “skin problems” with “no associated pain.” (AR 783.) Dr. 6 Varallo indicated that Plaintiff’s “right knee [was] painful at 7 the insertion of the sartorius” and otherwise noted normal 8 findings on examination. (AR 784.) He observed that Plaintiff’s 9 diabetes remained “uncontrolled,” prescribed a “[d]iet low in 10 simple carbohydrates,” and indicated that he would be “switched 11 to insulin” if his diabetes was not under control at the next 12 visit. (Id.) At a November 10, 2017 visit, Dr. Varallo 13 “stressed” the need for “weight reduction” and “reinforced and 14 advocated” that Plaintiff follow his diet. (AR 782.) He 15 “encouraged . . . 30 [minutes of] walking at least [three or four 16 times] per week.” (Id.) 17 On January 17, 2018, Dr. Varallo again noted that 18 Plaintiff’s diabetes was “uncontrolled” and prescribed a “[d]iet 19 low in simple carbohydrates” and “30 minutes of exercise daily.” 20 (AR 778.) On January 25, 2018, Plaintiff complained of a “cough, 21 runny nose and stuffy nose.” (AR 774.) Dr. Varallo noted a 22 “cobblestone appearance to [the] post pharynx and inside of the 23 nares” and otherwise normal findings on physical examination. 24 (AR 775.) He observed that Plaintiff’s diabetes remained 25 “uncontrolled” but showed “slight improvement.” (AR 776.) Dr. 26 Varallo again advised Plaintiff to follow a “[d]iet low in simple 27 carbohydrates” and to engage in “30 minutes of exercise daily.” 28 (Id.) Progress notes from February 1, 2018, state that 18 1 Plaintiff’s “A1C [was] in [an] increasing trend.” (AR 773.) He 2 reported that he was “walking ‘a lot nowadays.’” (Id.) Dr. 3 Varallo again noted that he “reinforced” Plaintiff’s need to 4 follow his diet and “encouraged” him to walk 30 minutes three or 5 four times a week. (Id.) On April 2, 2018, Dr. Varallo noted 6 that Plaintiff’s “[l]ast A1C was 9.1,” “reinforced” the need to 7 follow his diet, and again “encouraged” him to walk regularly. 8 (AR 772.) 9 c. State-agency consultants and reviewers 10 On July 16, 2013, Plaintiff underwent a complete internal- 11 medicine evaluation by Dr. Rocely Ella-Tamayo18 at Defendant’s 12 request. (AR 286-91.) Plaintiff presented with “[d]iabetes 13 mellitus,” “[h]igh blood pressure,” and “[c]hest pain” and 14 reported symptoms of “occasional numbness and tingling sensation 15 of the extremities,” “nocturia,” “occasional headache,” “rare 16 dizziness without ankle swelling,” and “occasional shortness of 17 breath and diaphoresis.” (AR 286-87.) He said he was capable of 18 “walk[ing two] blocks” and “pick[ing] up about 10 pounds,” and 19 his daily activities included “driv[ing] sometimes,” “help[ing] 20 with light housework,” “walk[ing] in the yard,” “go[ing] on 21 errands,” and “go[ing] to the doctor.” (AR 287.) Dr. Ella- 22 Tamayo noted on physical examination that Plaintiff was “obese” 23 and recorded his blood pressure as “160/90,” but examination 24 findings were otherwise normal. (AR 288-90.) She diagnosed him 25 26 18 Dr. Ella-Tamayo primarily practices internal medicine. 27 See Cal. Dep’t Consumer Aff. License Search, https:// search.dca.ca.gov (search for “Ella-Tamayo” under “License Type,” 28 “Physician’s and Surgeon’s”) (last visited May 12, 2020). 19 1 with “[d]iabetes mellitus,” “[h]ypertension,” “[c]oronary artery 2 disease status post 1 coronary artery stent placement with 3 history of angina pectoris,” and “[o]besity.” (AR 290.) She 4 opined that he was restricted in “pushing, pulling, lifting, and 5 carrying to about 20 pounds occasionally, and about 10 pounds 6 frequently,” his “[s]itting [was] unrestricted,” he was “able to 7 stand and walk 6 hours out of an 8-hour workday with normal 8 breaks,” he could “kneel without restriction” and “squat 9 frequently,” and he had “no significant functional impairment 10 [of] the hands.” (AR 291.) 11 On August 12, 2013, state-agency physician V. Phillips19 12 reviewed Plaintiff’s records and generally agreed with Dr. Ella- 13 Tamayo’s findings, differing from them only in finding that 14 Plaintiff could sit (with normal breaks) for a total of about six 15 hours in an eight-hour workday, had no limitations for pushing or 16 pulling other than those for lifting and carrying, and had no 17 postural, visual, communicative, or environmental limitations. 18 (AR 54-55.) On December 16, 2013, state-agency physician 19 C. Friedman20 reviewed Plaintiff’s records and adopted Dr. 20 Phillips’s findings. (AR 65-66.) 21 2. Plaintiff’s statements and testimony 22 In Plaintiff’s undated initial Disability Report, he stated 23 24 19 Dr. Phillips primarily practices family or general medicine. (See AR 47 (showing signature code of 12)); Soc. Sec. 25 Admin., Program Operations Manual System (POMS) DI 24501.004 (May 26 5, 2015), https://secure.ssa.gov/apps10/poms.nsf/lnx/0424501004 (signature code 12 indicates family or general practice). 27 20 Dr. Friedman’s medical specialty is not apparent from the 28 record. 20 1 that his ability to work was limited by “[h]igh blood pressure,” 2 “[d]iabetes,” and “[s]tint [sic] in artery.” (AR 142.) In a 3 questionnaire dated June 28, 2013, he claimed that “[f]atigue,” 4 “weakness,” and “[s]hortness of [b]reath” prevented him from 5 carrying out a normal workday. (AR 177.) 6 At the October 8, 2014 hearing, Plaintiff testified that he 7 last worked in January 2010. (AR 29.) He “got laid off” because 8 after he “had a stent put in one of [his] arter[ies],” he found 9 “it very difficult health-wise to travel a lot.” (Id.) He 10 testified that when he traveled by plane to Saudi Arabia and 11 Egypt earlier that year, he wound up “unconscious” on the plane. 12 (AR 30.) He woke up, but “when [he] arrived, [he] couldn’t stand 13 up,” he “was dizzy,” and “they had to bring a wheelchair.” (Id.) 14 He testified that he became “fatigued” “when [he] d[id] any 15 physical exercising.” (AR 31.) Although he “used to jog” “2 16 miles no problem,” “now if [he] walk[ed] 15 minutes,” he got 17 “dizzy” and had “hard breath.” (Id.) He would then have to lie 18 or sit down for “at least” 30 minutes. (Id.) He got “very 19 fatigued” after “pull[ing a] laundry basket for [his] wife” for 20 “50 feet.” (Id.) He said he could not work in a sales job that 21 did not require travel because he got “fatigued after one hour” 22 and his “eyes started to get blurry.” (AR 33-34.) He also could 23 not work as a car salesman because he could not do the “mov[ing] 24 around” and “physical work” required “to deliver a car,” among 25 other things. (AR 34.) He testified that if he walked 100 feet, 26 his eyes got “numby” and he felt “fatigue[d].” (AR 37.) He 27 could not “read for more than 10 or 15 minutes” before his vision 28 got “blurry.” (AR 38.) 21 1 At the July 19, 2018 hearing, Plaintiff testified that since 2 the previous hearing, he had “had a massive heart attack” and 3 bypass surgery. (AR 379.) He testified that he now “became 4 fatigued” “if [he] d[id] even very light work at all to help 5 [his] wife,” he “los[t] focus,” and his memory was “not as good 6 as it used to be.” (Id.) He had “started losing records of 7 dates,” could not “remember the name[s]” of his medications, and 8 he “sometimes” forgot instructions his wife gave him. (AR 380.) 9 He also testified that he could no longer “play tennis, swim, 10 [or] hike.” (Id.) He got out of breath “after like 10, or 11 maximum 15 minutes” if he tried to do things or moved around. 12 (AR 381.) His voice was becoming “weaker,” and if he spoke in a 13 loud voice he became “more fatigued.” (AR 381-82.) The fatigue 14 “became worse after the surgery.” (AR 382.) He testified that 15 “[b]efore the surgery, it was a little bit longer, 15, 20 16 minutes” before he became out of breath or felt tired. (Id.) 17 When he felt tired, he had to “lie down[] or sit down” for “30 18 minutes[] to 45 minutes” before resuming even “very light” 19 activities. (Id.) 20 3. The ALJ’s decision 21 The ALJ found Plaintiff’s “statements concerning the 22 intensity, persistence and limiting effects of [his] symptoms” 23 “not entirely consistent with the medical evidence and other 24 evidence in the record.” (AR 365.) 25 The ALJ first considered the objective medical evidence 26 supporting Plaintiff’s claims of fatigue, weakness, and shortness 27 of breath, noting that although “[h]istorical treatment records 28 document [his] diagnosis of coronary artery disease,” he 22 1 “underwent stenting of [a] coronary artery” in 2008. (AR 365.) 2 She noted that “[p]rogress notes from 2008 and 2009 reflect some 3 reports of chest pain, but no significant cardiac functional 4 abnormalities, with improvement[] in [Plaintiff’s] reported 5 symptoms over that period.” (Id.) Stress testing on September 6 4, 2009, “yielded the assessment of ‘very good functional 7 capacity.’” (AR 365 (quoting AR 227).) A cardiology 8 consultation report from June 2011 indicated that Plaintiff “had 9 experienced no chest pain since 2008 and . . . reported playing 10 sports and remaining very active without difficulty.” (AR 365-66 11 (citing AR 350).) In September 2011, Plaintiff “reported 12 increased fatigue,” but progress notes indicated “inconsistent 13 medication compliance.” (AR 366 (citing AR 348).) In December 14 2011, Plaintiff “reported the ability to play tennis for 30-45 15 minutes without severe fatigue.” (Id. (citing AR 344).) She 16 also considered cardiology notes from May 2013, which 17 “indicate[d] that [Plaintiff] denied any shortness of breath, 18 dizziness, lightheadedness, palpitations, or syncope.” (Id. 19 (citing AR 278).) She specifically noted that Plaintiff’s 20 treating cardiologist stated on May 2, 2013, that he could “work 21 in any field without restrictions.” (Id. (citing AR 331).) She 22 observed that treatment notes from November 2013 “reflect[ed] no 23 significant functional deficiencies upon physical examination[] 24 and no treatment recommendation beyond continuation of [his] 25 medications.” (Id.) A July 14, 2014, cardiac evaluation report 26 showed “no reported sympomatology” and no “significant 27 irregularities.” (Id. (citing AR 315).) 28 The ALJ also discussed notes indicating that Plaintiff “had 23 1 a heart attack in November of 2015 and underwent five-vessel 2 coronary bypass surgery.” (Id. (citing AR 554-98, 746).) But 3 she noted that “follow-up notes in 2016, 2017 and 2018 indicated 4 [he] was doing well and he denied chest pains, shortness of 5 breath, orthopnea, dizziness, syncope, palpitations, or lower 6 extremity edema.” (Id.) The ALJ also observed that Plaintiff’s 7 “diabetes mellitus was being conservatively managed with 8 medication[],” “[h]is physical examinations were largely 9 unremarkable for any acute cardiovascular or neurological 10 issues,” and he “was regularly encouraged to exercise at least 30 11 minutes a day by walking, which indicates that his doctor felt he 12 was capable of greater exertion than the sedentary lifestyle he 13 testified to at the hearing.” (Id. (citing AR 699, 701, 703, 14 764, 782, 797).) 15 The ALJ discussed Plaintiff’s treatment for right knee pain 16 in April 2017. (Id.) But “[h]is examination indicated a 17 negative Appley’s [sic] test and no effusion.” (Id.; see AR 609- 18 10.) Plaintiff “was given a knee brace and referred to the 19 orthopedics department.” (AR 366-67 (citing AR 609-10, 617-18).) 20 She also noted that “X-ray imaging of the joint showed normal 21 findings,” and there was “no indication of further treatment for 22 knee pain or any other musculoskeletal condition.” (AR 367 23 (citing AR 602-608, 662).) She remarked on the evidence 24 documenting Plaintiff’s obesity and observed that his “weight, 25 including the impact on his ability to ambulate as well as his 26 other body systems, has been considered.” (Id.) 27 The ALJ summarized the medical records, stating: 28 Overall, the medical records indicate that 24 1 [Plaintiff’s] history of coronary artery disease caused 2 minimal functional limitations prior to November 2015 in 3 light of the benign workups prior to that time, as well 4 as [his] reported physical activities that included 5 playing sports without significant fatigue or pain. 6 While he unfortunately had a heart attack in November of 7 2015, the notes convey that he recovered from the 8 incident and related bypass surgery relatively quickly, 9 as the subsequent examination and diagnostic findings 10 revealed little to no cardiovascular or neurological 11 abnormalities. [He] was also encouraged to exercise by 12 walking throughout his course of treatment. 13 (Id.) 14 The ALJ also discussed the medical-opinion evidence. First, 15 Plaintiff “underwent a complete internal medicine evaluation by 16 Dr. Tamayo on July 16, 2013.” (AR 366 (citing AR 284-94).) 17 Although Plaintiff reported “chest pain and shortness of breath 18 upon exertion,” physical examination revealed “no physical 19 abnormalities,” and he “demonstrated normal gait, strength, 20 sensation, and range of motion in all areas, with no neurological 21 deficiencies evident.” (Id. (citing AR 286-91).) The ALJ noted 22 that “Dr. Tamayo . . . opined that [Plaintiff] retained the 23 capacity to perform a range of work at the light exertional 24 level.” (Id.) She gave “little weight” to the opinion because 25 it did “not adequately take into account [Plaintiff’s] subjective 26 reports of fatigue and shortness of breath on exertion.” (Id.) 27 The ALJ also discussed the opinions of state-agency 28 physicians Phillips and Friedman, who opined that Plaintiff 25 1 “could perform a full range of light work.” (AR 367 (citing AR 2 48-57, 59-69.) She gave those opinions “little weight” as well 3 because the “evidence received at the time of the most recent 4 hearing supports a finding of greater functional limitation than 5 reflected in the opinions of these sources.” (Id.) 6 Ultimately, the ALJ concluded that Plaintiff’s symptoms 7 would limit him to a range of sedentary work and that he was 8 capable of performing his past relevant work as a sales manager 9 as generally performed in the national economy. (AR 364, 367- 10 68.) Therefore, she found him not disabled. (AR 369.) 11 C. Analysis 12 As an initial matter, the ALJ largely accepted Plaintiff’s 13 self-reported limitations in finding that he was capable of less 14 than the full spectrum of sedentary work. Indeed, his complaints 15 mostly concerned fatigue, weakness, and shortness of breath on 16 exertion (see AR 177 (questionnaire answers), 701 (reporting in 17 May 2016 that he gets “fatigued with exertion”)), and the ALJ 18 concluded that the agency doctors’ finding that he could perform 19 a range of light work did “not adequately take into account [his] 20 subjective reports of fatigue and shortness of breath on 21 exertion.” (AR 366.) Therefore, the ALJ limited him to “a range 22 of sedentary work.” (AR 364);21 see § 404.1567(a) (sedentary 23 work requires “lifting no more than 10 pounds at a time” and 24 “occasionally lifting or carrying articles like docket files, 25 26 21 The ALJ noted Plaintiff’s statement to a doctor in April 2017 that he injured his knee a few weeks prior while “carrying a 27 heavy load” (AR 366-67 (citing AR 609-10, 617-18)), which was inconsistent with his allegations of being unable to lift or 28 carry much weight because of fatigue. 26 1 ledgers, and small tools”); see also DOT 163.167-018, 1991 WL 2 647311 (sales-manager position requires “exerting up to 10 pounds 3 of force occasionally” “and/or a negligible amount of force 4 frequently” “to lift, carry, push, pull, or otherwise move 5 objects, including the human body”). In finding his statements 6 “not entirely consistent” with the medical records (AR 365), the 7 ALJ implicitly rejected only his allegation that he needed 30 to 8 45 minutes of rest after engaging in 10 to 15 minutes of 9 activity. (AR 364); cf. § 404.1567(a). 10 To the extent she discounted Plaintiff’s subjective 11 symptoms, she provided clear and convincing reasons supported by 12 substantial evidence for doing so. First, she properly concluded 13 that his claims were inconsistent with the objective medical 14 evidence (see AR 365), which is a valid basis for discounting a 15 claimant’s subjective symptom testimony. Morgan, 169 F.3d at 16 600; § 404.1529(c)(2). Second, she considered “other evidence” 17 from Plaintiff’s medical sources, including “longitudinal record 18 of any treatment and its success or failure,” SSR 16-3p, 2016 WL 19 1119029, at *6 (Mar. 28, 2016); § 404.1529(c)(3), the doctors’ 20 opinions, and Plaintiff’s daily activities. 21 For example, contrary to Plaintiff’s claims of disabling 22 fatigue, weakness, and shortness of breath from coronary artery 23 disease (see AR 177, 701), the objective medical evidence 24 demonstrated no significant cardiac functional deficits. The 25 January 2015 echocardiogram showed normal findings. (AR 719-20.) 26 The November 2015 echocardiogram demonstrated septal-wall 27 dyskinesis and mild concentric left ventricular hypertrophy, but 28 no diastolic dysfunction, preserved right ventricular function, 27 1 and otherwise normal findings. (AR 709-10.) The progress notes 2 consistently demonstrated normal physical-examination findings. 3 (See, e.g., AR 327, 329, 332, 334, 336, 338, 340, 342, 344, 346, 4 348, 350, 699, 701, 703, 705, 707, 711-12, 713, 715, 717.) 5 As to the other evidence, the treatment records demonstrated 6 that Plaintiff’s symptoms improved following his 2008 stent and 7 2015 coronary bypass surgery. (See AR 350 (Plaintiff reporting 8 in June 2011 that he had had no further angina since his stent 9 placement in May 2008 and that he could play sports and remain 10 “very active” without chest pain or shortness of breath), 699-700 11 (Plaintiff reporting in December 2016 that he was doing well and 12 denying any chest pain, shortness of breath, orthopnea, 13 dizziness, syncope, palpitations, or lower extremity edema), 773 14 (Plaintiff reporting in February 2018, seven months after his 15 date last insured, that he was walking “a lot nowadays”; see also 16 AR 367 (ALJ finding Plaintiff’s statements inconsistent with 17 medical evidence and that evidence as whole supported RFC).) 18 Indeed, in the periods following the 2008 stent and the 2015 19 coronary bypass surgery, Plaintiff repeatedly denied cardiac 20 symptoms and was consistently encouraged to exercise regularly. 21 (See, e.g., AR 702 (Dr. Deits observing in May 2016 that 22 Plaintiff should “progressively increase his exercise” and 23 finding that he was not “disabled from a cardiac POV”), 764 24 (Plaintiff reporting in March 2018 that he had no chest pain, 25 shortness of breath, orthopnea, dizziness, syncope, palpitations, 26 or lower extremity edema).) 27 The ALJ’s finding that the objective and other medical 28 evidence undermined his symptom allegations was supported by the 28 1 record. The echocardiogram results, physical-examination 2 findings, doctors’ opinions, and Plaintiff’s lack of cardiac 3 symptoms all indicated that he could perform sedentary work. 4 Notably, Plaintiff does not identify any record evidence 5 undermining the ALJ’s discounting of his subjective symptom 6 statements as “not entirely consistent” with the medical and 7 other evidence. (AR 365; see generally J. Stip. at 4-13.) 8 Instead, he contends that the ALJ did not articulate a 9 “sufficient articulated rationale” for discounting them (J. Stip. 10 at 7), arguing that her reasons were inadequate under Bunnell v. 11 Sullivan, 947 F.2d 341, 345 (9th Cir. 1991) (en banc) (J. Stip. 12 at 8; see id. at 7-11). Although Plaintiff is correct that 13 subjective symptom testimony cannot be rejected on the sole basis 14 that it is not fully corroborated by objective medical evidence, 15 see Burch, 400 F.3d at 680 (citing Bunnell, 947 F.2d at 345); 16 § 404.1529(c)(2), the ALJ did not discount his symptoms solely on 17 that basis. She also found them inconsistent with “other 18 evidence” in the medical records, including the medical-opinion 19 evidence and Plaintiff’s daily activities. (See, e.g., AR 365-66 20 (noting statement in Plaintiff’s treatment records that he 21 reported playing sports and remaining very active without 22 difficulty); see also AR 366 (noting opinion from Plaintiff’s 23 treating cardiologist that he could work in any field without 24 restrictions).) 25 The ALJ’s holistic consideration of the treatment records 26 beyond simply the “objective medical evidence” in them was 27 proper. See § 404.1529(c)(2) & (3); George v. Berryhill, No. 28 1:16-cv-00335-GSA, 2017 WL 3383117, at *11 (E.D. Cal. Aug. 7, 29 1 2017) (ALJ properly discounted symptoms given lack of “objective” 2 medical evidence under § 404.1529(c)(2) and inconsistences with 3 medical opinions and observations about plaintiff’s symptoms). 4 And although Plaintiff claims that the ALJ did not “provide 5 specific, clear, and convincing reasons for his [sic] credibility 6 determinations beyond the boilerplate” (J. Stip. at 7), her 7 decision, as discussed, reflects a careful reading of all the 8 evidence, including the trajectory of Plaintiff’s symptoms before 9 and after his stent placement and coronary bypass surgery (see AR 10 365-67). 11 Plaintiff argues that the ALJ did not articulate his daily 12 activities as a reason to discount his testimony. (J. Stip. at 13 10.) He is incorrect. In addressing the inconsistencies in his 14 symptom testimony, the ALJ specifically noted that he reported 15 playing sports and remaining very active without difficulty and 16 playing tennis for 30 to 45 minutes without severe fatigue. (AR 17 365-66.) 18 The ALJ stated clear and convincing reasons, supported by 19 substantial evidence, to partially discount Plaintiff’s 20 subjective symptom testimony. Reversal is not warranted. 21 VI. CONCLUSION 22 Consistent with the foregoing and under sentence four of 42 23 U.S.C. § 405(g),22 IT IS ORDERED that judgment be entered DENYING 24 Plaintiff’s request for remand, AFFIRMING the Commissioner’s 25 26 22 That sentence provides: “The [district] court shall have power to enter, upon the pleadings and transcript of the record, 27 a judgment affirming, modifying, or reversing the decision of the Commissioner of Social Security, with or without remanding the 28 cause for a rehearing.” 30 1 || decision, and DISMISSING this action with prejudice. 2 3 |} DATED: May 29, 2020

JEAN ROSENBLUTH

4 U.S. MAGISTRATE JUDGE 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 25 26 27 28 31