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8 UNITED STATES DISTRICT COURT

9 CENTRAL DISTRICT OF CALIFORNIA

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11 LERAE C., Case No. 5:19-cv-02100-KES

12 Plaintiff,

MEMORANDUM OPINION AND

13 v.

ORDER

14 ANDREW M. SAUL, Commissioner of Social Security, 15 Defendant. 16

17

18 I.

19 PROCEDURAL BACKGROUND

20 In March 2016, Plaintiff Lerae C. (“Plaintiff”) applied for social security 21 disability benefits under Titles II and XVI alleging an onset date of February 1, 22 2012, and a last date insured of December 31, 2017. Administrative Record 23 (“AR”) 20, 159-73, 229. On September 21, 2018, the Administrative Law Judge 24 (“ALJ”) conducted a hearing at which Plaintiff, who was represented by counsel, 25 testified along with a vocational expert (“VE”). AR 38-63. On October 29, 2018, 26 the ALJ issued an unfavorable decision. AR 14-37. 27 The ALJ found that Plaintiff suffered from the severe impairments of 28 “osteoarthritis of the bilateral hips, osteoarthritis of the left shoulder, left shoulder 1 adhesive capsulitis, and status post left shoulder arthroscopy surgery.” AR 20. 2 The ALJ found that Plaintiff’s head tremors, anxiety disorder, and cervical and 3 lumbar spine issues were non-severe impairments. AR 21-22. 4 The ALJ found that, despite her impairments, Plaintiff had the residual 5 functional capacity (“RFC”) to perform light work with the following additional 6 limitations: 7 [T]he claimant can lift, carry, push, and pull up to 20 pounds 8 occasionally and 10 [pounds] frequently, can stand and or walk for 9 six hours with normal breaks, and can sit for six hours with normal 10 breaks. Pushing and pulling with left upper extremity is limited to 11 occasional, and overhead reaching with left upper extremity is limited 12 to occasional, with no limitations with respect to use of right. The 13 claimant can occasionally climb stairs and ramps, never climb ladders 14 and scaffolds, can occasionally balance, occasionally kneel, 15 occasionally stoop, occasionally crouch, and occasionally crawl. She 16 should avoid exposure to unprotected heights and avoid workplace 17 hazards. She should not operate a motor vehicle commercially. The 18 claimant should avoid exposure to extreme cold and avoid exposure 19 to heavy vibrations. 20 AR 24. 21 Based on this RFC and the VE’s testimony, the ALJ found that Plaintiff 22 could do her past work as a receptionist. AR 29. The ALJ made an alternative 23 finding that if restricted to “superficial interaction with people,” then Plaintiff 24 could work as a routing clerk and merchandise marker. AR 30, 59. The ALJ 25 concluded that Plaintiff was not disabled. AR 31. 26 II. 27 ISSUE PRESENTED 28 This appeal presents the sole issue of whether the ALJ erred in discounting 1 | Plaintiff’s subjective symptom testimony. (Dkt. 21, Joint Stipulation [“JS”’] at 5.) 2 The Ninth Circuit has “established a two-step analysis for determining the 3 | extent to which a claimant’s symptom testimony must be credited.” Trevizo v. 4 | Berryhill, 871 F.3d 664, 678 (9th Cir. 2017). “First, the ALJ must determine 5 | whether the claimant has presented objective medical evidence of an underlying 6 | impairment ‘which could reasonably be expected to produce the pain or other 7 | symptoms alleged.’” Lingenfelter v. Astrue, 504 F.3d 1028, 1036 (9th Cir. 2007) 8 || (citation omitted). “Second, if the claimant meets the first test, and there is no 9 | evidence of malingering, ‘the ALJ can reject the claimant’s testimony about the 10 | severity of her symptoms only by offering specific, clear and convincing reasons 11 | for doing so.’” Id. (citation omitted). If the ALJ’s assessment “is supported by 12 | substantial evidence in the record, [courts] may not engage in second-guessing.” 13 | Thomas v. Barnhart, 278 F.3d 947, 959 (9th Cir. 2002). 14 Il. 15 SUMMARY OF THE MEDICAL EVIDENCE 16 A. Plaintiff’s Mental Health. 17 Plaintiff completed some college coursework. AR 380. She worked as a 18 | receptionist for about five-and-a-half years. AR 45, 273. She reported that she 19 | stopped working in February 2012 due to anxiety. AR 45-46, 380. In February 20 | and March 2012, she received treatment from the Inland Psychiatric Medical 21 | Group. AR 340 Gnvoice for services without treating notes). After leaving her 22 || receptionist job, she looked for and obtained other work; she had earnings in 2014 23 | that were not substantial gainful activity.' AR 20, 46. 24 In March 2016, Plaintiff requested a “psych referral” from her primary care 25 | physician. AR 348. 26 In April 2016, she underwent a psychiatric consultative examination with 27 08 ‘Tn her IFP application, Plaintiff declared she last worked in 2012. (Dkt. 3.)

1 Dr. Rezapour. AR 379. At that time, she was not receiving mental health 2 treatment and her only medication was ibuprofen. AR 380. She appeared “very 3 anxious,” but she was “engaged and cooperative” and had “no difficulty interacting 4 with the clinic staff.” AR 379, 382. She could do “household chores, run errands, 5 shopping, and cooking”; she rode the bus independently and pursued gardening as 6 a hobby. AR 379-80. Dr. Rezapour diagnosed her with “generalized anxiety 7 disorder” with a Global Assessment of Functioning (“GAF”) score of 66.2 AR 8 382. 9 On September 5, 2016 (about two weeks after hip replacement surgery), 10 Plaintiff met with Dr. Umugbe at Healthy and Happy America. AR 613. She rated 11 her anxiety level as 10/10 but reported, “I don’t like taking med not even aspirin 12 and I am on no med for my hip now not even pain med.” AR 614-15. Dr. 13 Umugbe did not establish a care plan, instead instructing Plaintiff to follow up in 14 three months “in case [she] wants meds at that time.” AR 615. 15 About seven months later in April 2017, Plaintiff obtained treatment from 16 Interim Psychiatric Care. AR 690. At that time, she was taking “no meds” with a 17 GAF score of 60. Id. In April 2017, she started taking Paxil (generic name 18 paroxetine). AR 323. By June 2017, she had filled a prescription for an anti- 19 anxiety medication, Vistaril (generic name atarax), but she had not yet taken it. 20 AR 694. By August 31, 2017, she had taken Vistaril 2 or 3 times as needed for 21 improved sleep. AR 693. 22 In December 2017, she reported, “No problem with meds.” AR 693. By 23 January 2018, she reported, “No problem with meds; no anxiety or panic attacks.” 24

25 2 A GAF score of 61-70 indicates “[s]ome mild symptoms (e.g., depressed mood and mild insomnia) or some difficulty in social, occupational, or school 26 functioning (e.g., occasional truancy, or theft within the household), but generally 27 functioning pretty well, [with] some meaningful interpersonal relationships.” Tagger v. Astrue, 536 F. Supp. 2d 1170, 1174 n.8 (C.D. Cal. 2008). 28 1 | AR 692. In June 2018, she reported, “No problem with Paxil [illegible]. Panic 2 | attack 2/per week.” AR 692. By August 2018, however, her doctors noted, “She 3 | stopped Paxil a month ago .... Now no meds for 8 weeks.” AR 691. Plaintiff 4 | reports starting a prescription for Cymbalta (generic name duloxetine) in July 5 | 2018. AR 323. 6 B. Plaintiff’s Physical Health. 7 1. 2012-2015 8 In February 2012, Plaintiff rated her pain as zero. AR 343. By November 9 | 2015, she had some difficulty walking but no “difficulty walking 2 blocks.” AR 10 | 353. She denied prior “serious illness” and “arthritis.” Id. She had smoked two 11 | packs of cigarettes per day for 35 years. AR 342, 352, 380. 12 She had several MRIs in December 2015 for her left hip and shoulder. AR 13 | 334-338, 397. She reported left shoulder pain going back two or three years and 14 || left hip pain going back four years. AR 335, 432, 443. She reported “moderate 15 | difficulty” engaging in hobbies, sporting activities, and driving. AR 406. 16 2. 2016 17 Based on the MRIs and physical examinations, in January 2016 Plaintiff was 18 | diagnosed as suffering from “osteoarthritis of the left hip” and designated a 19 | “candidate for total hip replacement arthroplasty.” AR 443-45. At that time, she 20 | was not taking any pain medication. AR 817. 21 P was diagnosed with “left shoulder rotator cuff tendonosis/tear,” see AR 22 | 432, and in mid-February 2016 received an injection to treat her shoulder pain. 23 | AR 439-40. The injection reduced her pain to 2/10 (AR 434) and her pain was still 24 | 2/10 by mid-March 2016, but the effects of the injection were “‘wearing off.” AR 25 | 430. 26 On April 21, 2016, she underwent an orthopedic consultative examination 27 | with Dr. Bernabe. AR 371. Plaintiff told Dr. Bernabe that her pain started 28 | “approximately 5 years ago” and that she had been “diagnosed with arthritis of the

1 left hip and left shoulder.” Id. At the examination, however, she displayed a 2 normal gait, could toe and heel walk, and had a full range of cervical and hip 3 motion, negative straight-leg raising tests, and 5/5 motor strength. AR 374. Dr. 4 Bernabe concluded that she could walk or stand 6 hours per day. AR 375. 5 By June 2016, Plaintiff’s left hip pain was 6/10, and she scheduled hip 6 replacement surgery for August. AR 498, 503-04. She also decided to proceed 7 with left shoulder arthroscopic rotator cuff repair.3 AR 388, 501. She was still 8 only taking ibuprofen “as needed for pain control.” AR 498. 9 On August 22, 2016, at a pre-operative appointment before her hip 10 replacement, Plaintiff reported that “she is unable to bend, squat, left, dress, drive, 11 stand, climb, or walk extensively.” AR 494, 557. She had “uneventful” surgery on 12 August 24, 2016, and she was discharged home in “stable” condition to pursue 13 physical therapy. AR 575, 582, 675. 14 In September 2016, she rated her hip pain as “fair” and told doctors that she 15 had stopped taking pain medication only eight days after the surgery. AR 674. 16 Her doctors opined that she was “doing well.” Id. 17 By October 2016, she was still reporting “moderate” hip pain and was 18 prescribed pain medications, but her doctors again assessed that she was “doing 19 well.” AR 672-73. In December 2016, she continued to report left hip pain, but 20 her motor strength had improved to 5/5. AR 669. 21 3. 2017 22 When Plaintiff complained of left hip pain in June 2017, her doctors 23 recommended home exercises. AR 659. X-rays taken that day revealed a “well- 24 positioned . . . total hip arthroplasty in excellent alignment.” Id. 25

26 3 Plaintiff acknowledged to her doctor that the shoulder injection had given 27 her relief for several weeks but she was “not interested in having this repeated.”

AR 504.

28 1 On August 9, 2017, she underwent left shoulder arthroscopic debridement. 2 AR 790. At her first post-operative appointment on August 21, she rated her pain 3 as 7/10; she was taking Norco “as needed for pain control.” AR 648. 4 By October 2017, she reported improvement to her shoulder; she had only 5 “minor aching pain and soreness” and rated her pain as 4/10. AR 646, 792. By 6 November 2017, she rated her shoulder pain as 3/10. AR 643, 794. By December 7 2017, her “chief complaint” was left hip pain with no mention of shoulder pain. 8 AR 797. 9 4. 2018 10 In January 2018, Plaintiff told her doctors that “she was riding her bike and 11 she crashed into a fence and hit her shoulder when she landed. [S]ince then she 12 has had some increase [in] pain.” AR 639. Even after the bicycle accident, she 13 rated her shoulder pain as only 2/10. AR 638. 14 When she complained of new lumbar pain in April 2018, Plaintiff’s doctors 15 referred her for pain management services and physical therapy. AR 717. In June 16 2018, she rated her hip pain as 4/10. AR 635. 17 Plaintiff started pain management treatment with Dr. Rho in July 2018. AR 18 829. She told Dr. Rho that she experienced an average pain level of 4-7/10 and 19 that her neck bothered her more than her hip. Id. She also reported that she “tries 20 to garden but in very small intervals.” AR 839. To treat her pain, she took “Norco 21 prn [as needed] rarely and ibuprofen in the past”; she wanted to “avoid opioids if 22 possible.” AR 829. Dr. Rho prescribed medication used to treat arthritic pain and 23 recommended “walking and home [exercise] program.” AR 832-33. 24 In August and September 2018, Plaintiff rated her pain as 5-6/10. AR 827, 25 837. After additional physical therapy, she reported decreased pain by October 26 2018. AR 837. 27 28 1 IV. 2 DISCUSSION 3 A. Summary of Plaintiff’s Testimony. 4 Plaintiff initially claimed disability as a result of osteoarthritis and bursitis 5 | affected her left hip and left shoulder, anxiety and panic attacks, head tremors, and 6 | periodontal disease. AR 64-65. 7 In a Function Report dated March 14, 2016, she reported that “acute anxiety 8 || and panic attacks make [her] unable to interact with people.” AR 220. 9 | Nevertheless, she lived with her family and performed homemaking chores, 10 | including caring for pets, cooking daily, sweeping, washing clothes, watering the 11 | garden, shopping, and paying bills. AR 221-23. She could “walk [her] small dog 12 | 1 time a day for 10 minutes” or “walk 1 block.” AR 221, 225. She could also go 13 | out alone, drive, and use public transportation. AR 223. She identified 14 | “gardening” as a hobby, but she did it “not any more as much” because she “lost 15 | interest.” AR 224. 16 At the September 2018 hearing, Plaintiff testified that she could not work 17 | due to “panic, and anxiety, my body condition.” AR 47. She anticipated needing 18 | neck and back surgery due to degenerative joint disease. AR 47, 51-52. 19 Regarding her August 2016 hip replacement surgery, she testified that her 20 | left hip was “still very tender.” AR 47. She explained that her hip “hurts to the 21 | touch” and when she walked, it felt like the metal was “shattering the top of my 22 | [femur] bone. And the pain goes down into my knee.” AR 52. Due to pain in her 23 | heels, she testified, “When I walk, it feels like I am stepping on knives.” AR 53. 24 Regarding her left shoulder, she testified that she had done three rounds of 25 | physical therapy, but she was still “in a lot of pain all the time.” AR 47, 52. 26 She testified that she had neck pain “all the time, and it shoots down into my 27 | left shoulder,” getting worse whenever she turned her head. AR 49. She also 28 || testified that she ‘‘always” had lower back pain, but it got worse when she walked;

1 | she rated her back pain as 7 or 8 out of 10 when walking. AR 51. On an average 2 | day, she could only be on her feet 5 to 15 minutes before needing to sit. AR 54-55. 3 Regarding her anxiety, she testified that she did not drive but could take 4 | public transportation. AR 49. She had panic attacks two or three times per week, 5 | and those attacks made her “just want to stay in my house and not deal with 6 | people.” AR 53-54. When she had an attack in a public place, like the bus, she 7 | would “pretend nobody is there, because I don’t have a choice ....”. AR 54. She 8 | reported taking Vistaril to treat her anxiety. Id. 9 B. Summary of the ALJ’s Decision. 10 The ALJ concluded that Plaintiff's statements about the intensity, 11 | persistence, and limiting effects of her symptoms were “not entirely consistent 12 | with the medical evidence and other evidence in the record.” AR 27. As reasons 13 | supporting this conclusion, the ALJ cited (1) inconsistencies between Plaintiff’ 14 | allegations and “the objective medical evidence”; (2) “contradictory statements 15 | regarding [Plaintiff’s] symptoms and treatment’; (3) inconsistencies between 16 | Plaintiffs allegations and her activities; and (4) a finding that Plaintiff’ 17 | “symptoms have improved or stabilized with treatment.” AR 27, 29. 18 C. Analysis of the ALJ’s Reasons for Discounting Plaintiff's Testimony. 19 1. Reason One: Inconsistent with Medical Evidence. 20 The ALJ noted Plaintiff’s testimony that she has constant, disabling left 21 | shoulder pain. AR 25. The ALJ contrasted this testimony with records showing 22 | successful shoulder surgery and improved range of motion from post-operative 23 | physical therapy. AR 26, citing AR 648-49 (8/21/17 progress notes); AR 646-47 24 | (10/4/17 progress notes: “Patient states her shoulder is improving. She reports 25 | minor aching pain ... [and] denies taking any medication for pain control at this 26 | time”; she is “doing well” with “good motion in the shoulder’); AR 643-44 27 | (11/28/17 progress notes: “patient states that the problem is better’ and “pain level 28 | 1s a 3/10”); AR 831 (7/17/18 physical examination: “Shoulder ROM — patient is

1 able to touch hands above head with minimal pain”). 2 Similarly, the ALJ noted Plaintiff’s testimony that she has had constant left 3 hip pain and contrasted it with records from after her August 2016 surgery. AR 4 25-26. Those records showed diminishing pain over time. AR 672-63 (10/5/16: 5 Plaintiff reported “moderate” pain but had a normal range of hip motion in every 6 direction except flexion); AR 669-70 (12/7/16: Plaintiff reported some groin pain 7 and numbness; doctor observed motor strength of 5/5 and recommended home 8 exercises with a 6-month follow up); AR 658-59 (6/7/17: Plaintiff reported hip 9 pain, but doctor observed 5/5 motor strength and unchanged ROM, again 10 recommending home exercises); AR 639 (1/23/18: Plaintiff was bike riding); AR 11 635-36 (6/13/18: Plaintiff rated her hip pain 4/10; “bursitis left hip resolved”). 12 Finally, Plaintiff testified that when walking, she felt like her femur was 13 shattering, felt like she was stepping on knives, and experienced back pain she 14 rated as 7/10. AR 51-53. The ALJ contrasted this with numerous records showing 15 that Plaintiff walked with a normal gait, both before and after her August 2016 hip 16 replacement. AR 26, citing AR 697 (1/22/16); AR 699 (3/4/16); AR 373 17 (4/21/16); AR 379 (4/23/16); AR 701 (5/20/16); AR 703 (9/14/16); AR 705 18 (12/16/16); AR 716 (4/10/18). 19 All these contrasts provide substantial evidentiary support for the ALJ’s 20 conclusion that Plaintiff’s symptom testimony was inconsistent with the objective 21 medical evidence. While subjective pain testimony cannot be rejected on the sole 22 ground that it is not fully corroborated by objective medical evidence, the medical 23 evidence is still a relevant factor in determining the severity of the claimant’s pain 24 and its disabling effects. Burch v. Barnhart, 400 F.3d 676, 681 (9th Cir. 2005). 25 2. Reason Two: Contradictory Symptom and Treatment Reporting. 26 a. Panic Attacks. 27 Plaintiff testified that panic attacks caused her to leave her receptionist job in 28 2012 and that she continued to suffer from such severe anxiety that she could not 1 deal with people outside her house. AR 53-54, 220. At the September 2018 2 hearing, she reported panic attacks 2 or 3 times per week. AR 53. 3 The ALJ contrasted this testimony with medical records showing that 4 Plaintiff did not suffer from debilitating panic attacks throughout her period of 5 claimed disability. The ALJ cited multiple medical records showing that Plaintiff 6 was pleasant and cooperative when engaging with medical staff. AR 27, citing AR 7 379-81 (4/23/16); AR 494 (8/22/16); AR 716 (4/10/18). During the 2016 8 encounters, Plaintiff was not taking any medication to treat her mental illness. AR 9 380, 690. She began taking anti-anxiety medication in late 2017 (AR 693) and by 10 January 2018, she reported “no anxiety or panic attacks.” AR 692. Six months 11 later in June 2018, she reported two panic attacks per week, but she also stated, “I 12 am OK,” and her doctor assessed, “Cont. Current meds.” Id. By August 2018, 13 however, her doctors noted, “She stopped Paxil a month ago …. Now no meds for 14 8 weeks.” AR 691. 15 Substantial evidence supports the ALJ’s finding that Plaintiff did not 16 consistently suffer from frequent, disabling panic attacks. While Plaintiff reported 17 feeling worried or anxious to various medical providers, she has not cited (and the 18 Court has not seen) any medical records noting that her mental health symptoms 19 caused her to miss appointments or impaired her ability to interact with medical 20 staff. Instead, the medical evidence shows that even without treatment, Plaintiff 21 was able to interact appropriately with medical staff. When she began taking anti- 22 anxiety medication, her panic attacks decreased to none. When she stopped taking 23 any medication, they resumed. The inconsistency between Plaintiff’s allegations 24 and what she told her medical providers about the disabling nature of her panic 25 attacks was a clear and convincing reason for the ALJ to discount her symptom 26 testimony. 27 b. Inability to Drive. 28 The ALJ contrasted Plaintiff’s September 2018 testimony that she does not 1 drive (AR 49) with earlier evidence that she did drive. AR 27, citing AR 223 2 (4/4/16 function report); AR 199 (4/2/16 function report by husband); AR 381 3 (4/23/16 psychiatric evaluation). 4 Plaintiff argues that there is no contradiction, because while Plaintiff could 5 drive in 2016, she could not drive in 2018. (JS at 13.) 6 In March 2016, Plaintiff reported to her doctors that she had “moderate” 7 difficulty driving. AR 406. In August 2016, Plaintiff told her doctors that she was 8 “unable” to drive. AR 494. Ultimately, Plaintiff appears to have told her doctors 9 in 2016 that she had difficulty driving, whereas she did not tell the Commissioner 10 that in her function report. Plaintiff’s statements about driving by itself would not 11 be a clear and convincing reason to discount Plaintiff’s symptom testimony. 12 3. Reason Three: Inconsistent with Activities. 13 The ALJ observed that Plaintiff’s pain testimony was inconsistent with 14 gardening as a hobby and exercising by daily walking. AR 27. 15 In January 2016, Plaintiff completed a medical history questionnaire 16 indicating that she exercised regularly by walking daily for about 20 minutes. AR 17 818, 820. In March 2016, she reported walking 10 minutes per day. AR 221. In 18 January 2018, she was able to ride a bike. AR 639. These reported activities are 19 inconsistent with Plaintiff’s extreme hearing testimony, i.e., that whenever she 20 walks, she experiences 7/10 pain and feels like her femur is shattering and she is 21 stepping on knives. AR 51-53. Substantial evidence supports the ALJ’s finding 22 that Plaintiff exaggerated the degree to which her walking ability is limited by 23 pain.4 24 25 4 Plaintiff contends that the ALJ needed to show that Plaintiff’s testimony 26 was inconsistent with an ability to walk for a “substantial part” of her day. (See JS at 10-11.) Daily activities can demonstrate that a claimant’s subjective complaints 27 are exaggerated, even if those daily activities do not by themselves suggest an 28 ability to work full-time. See Valentine v. Astrue, 574 F.3d 685, 694 (9th Cir. 1 In April 2016, Plaintiff reported “gardening” as a hobby. AR 380. In July 2 2018, she reported that she “tries to garden but in very small intervals.” AR 839. 3 Plaintiff argues that the ALJ’s finding of inconsistency is unsupported because the 4 ALJ never asked how she gardened. (JS at 10.) Even in small intervals, gardening 5 requires walking and kneeling or stooping. Again, Plaintiff’s symptom testimony 6 was so extreme (i.e., that she cannot walk or turn her head without severe pain), the 7 ALJ could reasonably find it inconsistent with regularly performing even limited 8 gardening. 9 Regarding Plaintiff’s anxiety, the ALJ found that it caused only mild 10 functional limitations. AR 22. As support, the ALJ cited Plaintiff’s ability to 11 “perform household chores, run errands, shop, and cook,” as well as her ability to 12 use public transportation. AR 22-23. The ALJ also noted that Plaintiff had looked 13 for other work. AR 25. Plaintiff’s ability to shop, run errands, and ride the bus is 14 inconsistent with her testimony that her anxiety renders her unable to deal with 15 people. She admitted that she is able to persist through panic attacks when 16 sufficiently motivated, such as taking the bus to medical appointments. AR 54. 17 The ALJ cited activities showing that the functional limitations caused by 18 Plaintiff’s anxiety are not as severe as Plaintiff alleged. 19 4. Reason Four: Improvement with Treatment. 20 The ALJ summarized treating records for Plaintiff’s left shoulder and left 21 hip, noting post-surgical improvements. AR 25-26. The ALJ also summarized 22 treating records for Plaintiff’s anxiety. AR 27. The ALJ concluded, “The 23 claimant’s symptoms have improved or stabilized with treatment.” AR 29. 24 Substantial evidence supports the ALJ’s conclusion. Per the medical records 25 summarized above, Plaintiff’s shoulder and hip pain improved after surgery, 26 notwithstanding her reluctance to take pain medication. While Plaintiff argues that 27 2009). 28 1 | her pain returned (JS at 8), she cites no evidence undermining the ALJ’s 2 | conclusion that her pain, if managed with medication, would prevent her from 3 | doing light work.° Similarly, Plaintiff’s panic attacks decreased when she began 4 | taking anti-anxiety medication. See Nathan v. Colvin, 551 F. App’x 404, 407-08 5 | (9th Cir. 2014) (finding no error where ALJ did not incorporate claims of chronic 6 | pain, because claimant did not provide evidence “to refute the conclusion that the 7 | pain could be managed with proper medication’). 8 V. 9 CONCLUSION 10 For the reasons stated above, IT IS ORDERED that judgment shall be 11 | entered AFFIRMING the decision of the Commissioner. 12 13 thy 14 | DATED: September 16, 2020 Mind 6, Scot ? 15 KAREN E. SCOTT 6 United States Magistrate Judge

17 18 19 20 21 22 23 24 > Plaintiff also criticizes the ALJ for relying on medical opinions by doctors 25 || who did not consider Plaintiff's shoulder surgery or 2018 complaints of hip pain. (See JS at 7.) The ALJ considered both her shoulder surgery and her 2018 26 complaints. Furthermore, the ALJ assessed greater limitations than those assessed 27 | by these physicians out of “an abundance of caution . . . in consideration of records 08 received through hearing level and [Plaintiff's] testimony.” AR 28.

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