BACKGROUND AND SUMMARY OF ADMINISTRATIVE DECISIONS

17 18 On August 28, 2008, Plaintiff, formerly employed as a quality 19 assurance and fingerprint clerk, a school aide, and a customer service 20 representative (see AR 39-43, 253, 884-89), filed an application for 21 Disability Insurance Benefits alleging a disability onset date of August 22 16, 2004. (See AR 220-23). Plaintiff’s application was denied, 23 initially on December 16, 2008, and, on reconsideration on April 2, 24 2009. (See AR 100, 129-30). 25 26 December 3, 2010 Decision 27 28 On October 14, 2010, Plaintiff, represented by counsel, testified at a hearing before Administrative Law Judge (“ALJ”) Charles E. 1 Stevenson (“ALJ Stevenson”). (See AR 81-99). ALJ Stevenson also heard 2 testimony from medical expert Samuel Nafisi and vocational expert Alan 3 Boroskin. On December 3, 2010, ALJ Stevenson issued a decision denying 4 Plaintiff’s request for benefits. (See AR 105-17). 5 6 Applying the five-step sequential process, ALJ Stevenson found at 7 step one that Plaintiff had not engaged in substantial gainful activity 8 from August 16, 2004, the alleged onset disability onset date, though 9 March 31, 2010, her date last insured. (AR 107). At step two, ALJ 10 Stevenson determined that Plaintiff had the following severe 11 impairments: “disorder of the cervical spine by disc bulge; disorder of 12 the lumbar spine by disc bulging; status post hysterectomy; irritable 13 bowel syndrome, stable; anxiety; and depression.” (AR 107-08).3 At step 14 three, ALJ Stevenson determined that Plaintiff did not have an 15 impairment or combination of impairments that met or medically equaled 16 the severity of any of the listed impairments in the regulations. (AR 17 108-09). ALJ Stevenson then found that Plaintiff had the residual 18 functional capacity (“RFC”)4 to perform light work5 with certain 19 limitations. (AR 110-16). At step four, ALJ Stevenson found that 20 Plaintiff was able to perform past relevant work as a fingerprinting 21 clerk and as an administrative clerk, both as actually and generally 22 23 3 ALJ Stevenson found that Plaintiff’s other impairments -- 24 carpal tunnel syndorme in the right hand, and “tennis elbow” in the left hand -- were not medically determinable. (AR 108). 25 4 A Residual Functional Capacity is what a claimant can still do 26 despite existing exertional and nonexertional limitations. See 20 C.F.R. § 404.1545(a)(1). 27 5 “Light work involves lifting no more than 20 pounds at a time 28 with frequent lifting or carrying of objects weighing up to 10 pounds.” 20 C.F.R. § 404.1567(b). 1 performed. (AR 116). Accordingly, ALJ Stevenson found that Plaintiff 2 had not been under a disability as defined in the Social Security Act 3 from August 16, 2004 through March 31, 2010. (AR 116-17). 4 5 The Appeals Council granted Plaintiff’s request for review of ALJ 6 Stevenson’s decision and remanded the matter for further consideration 7 of Plaintiff’s maximum RFC and further evaluation of Plaintiff’s ability 8 to perform past relevant work. (AR 123-24). 9 10 November 2, 2012 Decision 11 12 On September 6, 2012, Plaintiff, represented by counsel, testified 13 at a hearing before ALJ Tamara Turner-Jones (“ALJ Turner-Jones”). (See 14 AR 35-78). ALJ Turner-Jones also heard testimony from vocational expert 15 Gloria Lasoff (“VE Lasoff”). On November 2, 2012, ALJ Turner-Jones 16 issued a decision denying Plaintiff’s request for benefits. (See AR 11- 17 21). After making essentially the same findings as ALJ Stevenson’s 18 decision at steps one two, and three (see AR 13-15), and finding that 19 Plaintiff had the RFC to perform light work with certain limitations 20 (see AR 15-19), ALJ Turner-Jones found that Plaintiff was not able to 21 perform any past relevant work. (AR 19). At step five, ALJ Turner- 22 Jones determined, based on Plaintiff’s age, education, work experience, 23 RFC, and VE Lasoff’s testimony, that there were jobs that existed in 24 significant numbers in the national economy that Plaintiff could have 25 performed. (AR 19-21). Accordingly, ALJ Turner-Jones found that 26 Plaintiff had not been under a disability as defined in the Social 27 Security Act from August 16, 2004 though March 31, 2010. (AR 21). 28 1 The Appeals Council denied Plaintiff’s request for review of ALJ 2 Turner-Jones’s decision (see AR 5). (AR 1-3). Plaintiff sought 3 judicial review of ALJ Turner-Jones’s decision. On September 2, 2015, 4 the Court vacated ALJ Turner-Jones’s decision and remanded the matter 5 for further proceedings based on ALJ Turner-Jones’s failure to properly 6 assess Plaintiff’s credibility and Plaintiff’s husband’s credibility. 7 (See AR 942-52). 8 9 July 27, 2016 Decision 10 11 On May 27, 2016, Plaintiff, represented by counsel, testified at 12 a hearing before ALJ Kenneth E. Ball (“ALJ Ball”). (See AR 879-907). 13 ALJ Ball also heard testimony from vocational expert David Rinehart (“VE 14 Rinehart”) On July 27, 2016, ALJ Ball issued a decision denying 15 Plaintiff’s request for benefits. (See AR 854-70). At step one, ALJ 16 Ball found that Plaintiff had not engaged in substantial gainful 17 activity from August 16, 2004 though March 31, 2010. (AR 856). At step 18 two, ALJ Ball determined that Plaintiff had the following severe 19 impairments: “degenerative disc disease of the cervical spine; 20 degenerative disc disease of the lumbar spine; irritable bowel syndrome; 21 anxiety; and depression.” (AR 856).6 At step three, ALJ Ball determined 22 that Plaintiff did not have an impairment or combination of impairments 23 that met or medically equaled the severity of any of the listed 24 impairments in the regulations. (AR 857-58). ALJ Ball then found that 25 Plaintiff had the RFC to perform light work with certain limitations. 26 (AR 858-68). At step four, ALJ Ball found that Plaintiff was not able 27 28 6 ALJ Ball found that Plaintiff’s other impairment -- history of menorrhagia, status post hysterectomy -- was nonsevere. (AR 856-57). 1 to perform any past relevant work. (AR 868-69). At step five, ALJ Ball determined, based on Plaintiff’s age, education, work experience, RFC, 2 and VE Rinehart’s testimony, that there were jobs that existed in 3 significant numbers in the national economy that Plaintiff could have 4 performed. (AR 869-70). Accordingly, ALJ Ball found that Plaintiff had 5 not been under a disability as defined in the Social Security Act from 6 August 16, 2004 though March 31, 2010. (AR 870). 7 8 Plaintiff sought judicial review of ALJ Ball’s decision. On 9 September 19, 2017, the Court vacated ALJ Ball’s decision and remanded 10 the matter for further proceedings based on ALJ Ball’s failure to 11 properly analyze Plaintiff’s subjective complaints and Plaintiff’s 12 husband’s statements. (See AR 1372-90). 13 14 March 13, 2019 Decision 15

16 On January 16, 2019, Plaintiff, represented by counsel, testified 17 at a hearing before ALJ Josephine Arno (“ALJ Arno”), who also heard 18 testimony from vocational expert Stephen Schmidt (“VE Schmidt). (See AR 19 1349-66). On March 13, 2019, ALJ Arno issued a decision denying 20 Plaintiff’s request for benefits. (See AR 1322-39). At step one, ALJ 21 Arno found that Plaintiff had not engaged in substantial gainful 22 activity from August 16, 2004 though March 31, 2010. (AR 1324). At 23 step two, ALJ Arno determined that Plaintiff had the following severe 24 impairments: “degenerative disc disease of the cervical spine; 25 degenerative disc disease of the lumbar spine; irritable bowel syndrome; 26 27 28 1 anxiety; and depression.” (AR 1324-25).7 At step three, ALJ Arno 2 determined that Plaintiff did not have an impairment or combination of 3 impairments that met or medically equaled the severity of any of the 4 listed impairments in the regulations. (AR 1325-27). 5 ALJ Arno then found that Plaintiff had the RFC to perform light 6 work with the following limitations: 7 Specifically, lift and carry 20 pounds occasionally and 10 pounds frequently; stand and walk for six hours out of an 8 eight-hour workday with regular breaks with the requirement to change positions briefly for one to three minutes each hour; 9 sit without limitation during an eight-hour workday with regular breaks; push and pull within the weight limits 10 indicated for lifting and carrying; reach overhead occasionally bilaterally; perform all postural activities 11 occasionally; must work within 100-yards distance from a bathroom; no work requiring a high-quota production rate pace, 12 such as rapid assembly line work; must avoid exposure to unprotected heights and moving mechanical parts of equipment, 13 tools, or machinery; understand, remember, and carry out instructions to perform tasks that are simple and routine, and 14 require only simple work-related decision; [and] have only occasional contact with the public and occasional interaction 15 with coworkers. 16 (AR 1327-37). 17 18 At step four, ALJ Arno found that Plaintiff was unable to perform 19 any past relevant work. (AR 1337). At step five, ALJ Arno determined, 20 based on Plaintiff’s age, education, work experience, RFC, and VE 21 Schmidt’s testimony, that there were jobs that existed in significant 22 numbers in the national economy that Plaintiff could have performed. 23 (AR 1337-39). Accordingly, ALJ Arno found that Plaintiff had not been 24 under a disability as defined in the Social Security Act from August 16, 25 2004 through March 31, 2010. (AR 1339). 26 27 28 7 ALJ Arno found that Plaintiff’s other impairment -- history of menorrhagia, status post hysterectomy -- was nonsevere. (AR 1324-25). 1 Plaintiff did not request that the Appeals Council review ALJ 2 Arno’s decision, and now seeks judicial review of ALJ Arno’s decision, 3 which stands as the final decision of the Commissioner. See 42 U.S.C. 4 §§ 405(g), 1383(c). 5 6

STANDARD OF REVIEW

7 8 This Court reviews the Commissioner’s decision to determine if it 9 is free of legal error and supported by substantial evidence. See 10 Brewes v. Comm’r, 682 F.3d 1157, 1161 (9th Cir. 2012). “Substantial 11 evidence” is more than a mere scintilla, but less than a preponderance. 12 Garrison v. Colvin, 759 F.3d 995, 1009 (9th Cir. 2014). “It means such 13 relevant evidence as a reasonable mind might accept as adequate to 14 support a conclusion.” Revels v. Berryhill, 874 F.3d 648, 654 (9th Cir. 15 2017). To determine whether substantial evidence supports a finding, 16 “a court must consider the record as a whole, weighing both evidence 17 that supports and evidence that detracts from the [Commissioner’s] 18 conclusion.” Aukland v. Massanari, 257 F.3d 1033, 1035 (9th Cir. 19 2001)(internal quotation omitted). As a result, “[i]f the evidence can 20 support either affirming or reversing the ALJ’s conclusion, [a court] 21 may not substitute [its] judgment for that of the ALJ.” Robbins v. Soc. 22 Sec. Admin., 466 F.3d 880, 882 (9th Cir. 2006).8 23 24 25 26 8 The harmless error rule applies to the review of 27 administrative decisions regarding disability. See McLeod v. Astrue, 640 F.3d 881, 886-88 (9th Cir. 2011); Burch v. Barnhart, 400 F.3d 676, 28 679 (9th Cir. 2005)(An ALJ’s decision will not be reversed for errors that are harmless). 8 1 PLAINTIFF’S CONTENTIONS 2 3 Plaintiff contends that ALJ Arno erred in failing to properly 4 assess Plaintiff’s RFC by failing to consider (1) the opinions of 5 Plaintiff’s treating physicians (Drs. Amin, Lineback and Flores); and 6 (2) Plaintiff’s subjective symptom testimony and the statements of 7 Plaintiff’s husband. (See Joint Stip. at 8-14, 22-25). 8 9 DISCUSSION 10 11 After consideration of the record as a whole, the Court finds that 12 the Commissioner’s findings are supported by substantial evidence and 13 are free from legal error. 14 15 A. ALJ Arno Provided Clear and Convincing Reasons for Rejecting 16 Plaintiff’s Subjective Symptom Testimony9 17 18 When assessing a claimant’s credibility regarding subjective pain 19 or intensity of symptoms, the ALJ must engage in a two-step analysis. 20 Trevizo v. Berryhill, 871 F.3d 664, 678 (9th Cir. 2017). First, the ALJ 21 must determine if there is medical evidence of an impairment that could 22 reasonably produce the symptoms alleged. Id. (citing Garrison v. 23 Colvin, 759 F.3d 995, 1014-15 (9th Cir. 2014)). “In this analysis, the 24 claimant is not required to show that her impairment could reasonably 25 be expected to cause the severity of the symptom she has alleged; she 26 27 9 The Court addresses Plaintiff’s claims of error non- 28 sequentially in order to address the arguments coherently. 9 1 need only show that it could reasonably have caused some degree of the 2 symptom.” Id. (emphasis in original)(citation omitted). “Nor must a 3 claimant produce objective medical evidence of the pain or fatigue 4 itself, or the severity thereof.” Id. (citation omitted). 5 6 If the claimant satisfies this first step, and there is no evidence 7 of malingering, the ALJ must provide specific, clear and convincing 8 reasons for rejecting the claimant’s testimony about the symptom 9 severity. Id. (citation omitted); see also Robbins v. Soc. Sec. Admin., 10 466 F.3d 880, 883 (9th Cir. 2006)(“[U]nless an ALJ makes a finding of 11 malingering based on affirmative evidence thereof, he or she may only 12 find an applicant not credible by making specific findings as to 13 credibility and stating clear and convincing reasons for each.”); Smolen 14 v. Chater, 80 F.3d 1273, 1284 (9th Cir. 1996)(“[T]he ALJ may reject the 15 claimant’s testimony regarding the severity of her symptoms only if he 16 makes specific findings stating clear and convincing reasons for doing 17 so.”). “This is not an easy requirement to meet: The clear and 18 convincing standard is the most demanding required in Social Security 19 20 cases.” Garrison, 759 F.3d at 1015 (citation omitted). 21 22 Where, as here, the ALJ finds that a claimant suffers from a 23 medically determinable physical or mental impairment that could 24 reasonably be expected to produce his alleged symptoms, the ALJ must 25 evaluate “the intensity and persistence of those symptoms to determine 26 the extent to which the symptoms limit an individual’s ability to 27 perform work-related activities for an adult.” Soc. Sec. Ruling (“SSR”) 28 10 1 16-3p, 2017 WL 5180304, at *3.10 SSR 16–3p eliminated the term 2 “credibility” from the Agency’s sub-regulatory policy. However, the 3 Ninth Circuit Court of Appeals has noted that SSR 16–3p: 4 makes clear what [the Ninth Circuit’s] precedent already required: that assessments of an individual’s testimony by an 5 ALJ are designed to “evaluate the intensity and persistence of symptoms after the ALJ finds that the individual has a 6 medically determinable impairment(s) that could reasonably be expected to produce those symptoms,” and not to delve into 7 wide-ranging scrutiny of the claimant’s character and apparent truthfulness. 8 9 Trevizo, 871 F.3d at 678 n.5 (quoting SSR 16–3p)(alterations omitted). 10 11 In discrediting the claimant’s subjective symptom testimony, the 12 ALJ may consider: “ordinary techniques of credibility evaluation, such 13 as . . . prior inconsistent statements concerning the symptoms, and 14 other testimony by the claimant that appears less than candid; 15 unexplained or inadequately explained failure to seek treatment or to 16 follow a prescribed course of treatment; and the claimant’s daily 17 activities.” Ghanim v. Colvin, 763 F.3d 1154, 1163 (9th Cir. 2014) 18 (citation omitted). Inconsistencies between a claimant’s testimony and 19 conduct, or internal contradictions in the claimant’s testimony, also 20 may be relevant. Burrell v. Colvin, 775 F.3d 1133, 1137 (9th Cir. 21 2014). In addition, the ALJ may consider the observations of treating 22 and examining physicians regarding, among other matters, the functional 23 restrictions caused by the claimant’s symptoms. Smolen, 80 F.3d at 24 25 10 SSR 16-3p, (which became effective on March 28, 2016), is applicable to this case, because it was in effect on the date ALJ Arno’s 26 decision became the final decision of the Commissioner, see 20 C.F.R. § 404.968(a)(1) (prescribing sixty-day period to request Appeals Council 27 review). 20 C.F.R. § 404.1529, the regulation on evaluating a claimant’s symptoms, including pain, has not changed. 28 11 1 1284; accord Burrell, supra. However, it is improper for an ALJ to 2 reject subjective testimony based “solely” on its inconsistencies with 3 the objective medical evidence presented. Bray v. Comm’r of Soc. Sec. 4 Admin., 554 F.3d 1219, 1227 (9th Cir. 2009)(citation omitted). 5 6 The ALJ must make a credibility determination with findings that 7 are “sufficiently specific to permit the court to conclude that the ALJ 8 did not arbitrarily discredit claimant’s testimony.” Tommasetti v. 9 Astrue, 533 F.3d 1035, 1039 (9th Cir. 2008)(citation omitted); see 10 Brown-Hunter v. Colvin, 806 F.3d 487, 493 (9th Cir. 2015)(“A finding 11 that a claimant’s testimony is not credible must be sufficiently 12 specific to allow a reviewing court to conclude the adjudicator rejected 13 the claimant’s testimony on permissible grounds and did not arbitrarily 14 15 discredit a claimant’s testimony regarding pain;” citation omitted). 16 Although an ALJ’s interpretation of a claimant’s testimony may not be 17 the only reasonable one, if it is supported by substantial evidence, “it 18 is not [the court’s] role to second-guess it.” Rollins v. Massanari, 19 261 F.3d 853, 857 (9th Cir. 2001). 20 21 // 22 // 23 // 24 25 26 27 28 12 1 1. Plaintiff’s Subjective Statements and Testimony1 2 3 Plaintiff completed a Pain Questionnaire, dated September 4, 2008, 4 (see AR 267-69), in which she described a constant pain in her neck, 5 upper back, lower back, right wrist, upper shoulder, and stomach 6 (irritable bowel syndrome, acid reflux) that spreads down to her legs, 7 and is brought on by any movement, i.e., standing, bending, sleeping, 8 walking, getting dressed, going to the restroom, driving a car, 9 swallowing food, and by sitting for short periods. (AR 267). Her pain 10 causes her to stop an activity every ten to fifteen minutes. (AR 269). 11 She is able to walk to her home mailbox and to sit (usually lying down 12 on her side) and/or stand for five to ten minutes at a time. (AR 269). 13 Her usual daily activities include trying to stand up, taking a hot 14 15 bath, “eat[ing] something,” lying down on the couch for three hours, 16 doing dishes, lying down again for thirty minutes, putting in a load of 17 laundry, lying down again, dressing, making the bed, finishing the 18 dishes, and lying down again. (AR 268). Although she can go to the 19 post office or grocery store without assistance, it takes her a couple 20 of days to recover; she tries to have her husband, son or sister drive 21 her for errands and her sister takes her to Bible study. (AR 268-69). 22 She is not able to keep up with her chores, and needs assistance with 23 mopping, doing laundry, making dinner, and vacuuming. (AR 268-69). She 24 25 1 Plaintiff submitted two Pain Questionnaires and two Adult 26 Function Reports, and testified at four administrative hearings. The Court assumes, unless it is clear that Plaintiff was referring to a 27 prior time frame, that Plaintiff’s statements and testimony about her subjective symptoms referred to the symptoms she was experiencing at the 28 time the statements were made. 13 1 is not able to maintain her composure when asked questions. (Id.). A 2 doctor told her she was not a good candidate for surgery because her 3 degenerative disc will not improve. (AR 268). Whether she has stomach 4 surgery is still in question. (Id.). The medicine she takes for her 5 pain -- Lexapro 10 mg,2 Motrin 800 mg, Zantac 300 mg, Pepto Bismol, and 6 heat patches -- takes some of the edge off. (AR 267). 7 8 Plaintiff completed an Adult Function Report, dated September 4, 9 2008, with the assistance of another person, (see AR 270-77), reporting 10 daily activities that are generally consistent with those alleged in the 11 Pain Questionnaire. She has difficulty sleeping at night because of 12 stomach aches and pain in the back, arm and wrist. (AR 270-71). Her 13 conditions affect her ability to dress, bathe, care for her hair, feed 14 15 herself, and use the toilet. (AR 271). She needs reminders to brush her 16 teeth, take medicine, and go places. (AR 272-74). She prepares her own 17 meals (sandwiches, frozen dinners) once a week; her pain prevents her 18 from preparing food most days and when she cooks dinner once a week, it 19 takes her 2.5 hours during which she has to lie down and rest. (Id.). 20 She needs help from her husband and sons to do household chores 21 (laundry, grocery shopping, picking up medication, weeding, watering 22 flowers). (AR 272, 275). She is able to go out alone, but is afraid 23 that she will not be able to drive herself home, or that she will have 24 a panic attack or her throat will close up. She shops in stores for 25 26 2 “Lexapro is name-brand escitalopram oxalate, which is used to treat depression and anxiety by helping to restore the balance of 27 serotonin in the brain.” Alfred G. v. Berryhill, 2019 WL 134551, *3 n.8 (C.D. Cal. Jan. 8, 2019). 28 14 1 small grocery items once a week or once every other week. (Id.). She 2 is able to pay bills (with her husband’s help), but cannot count change, 3 handle a savings account, or use a checkbook/money orders (due to issues 4 with adding and subtracting and with her thought process). (AR 273-74). 5 She no longer has any hobbies and interests because of her pain. (Id.). 6 She sometimes talks on the phone with others, and she goes to Bible 7 study once a week (her sister takes her) and to church twice a month. 8 Her conditions affect her ability to lift, squat, bend, reach, walk, 9 sit, kneel, talk, hear, stair-climb, see, memory, complete task (she 10 does not finish what she starts), concentrate (she can pay attention for 11 three minutes), understand, follow written and spoken instructions, use 12 her hands and get along with others. (AR 275). She does not handle 13 stress well; stress causes her irritable bowel syndrome and acid reflux. 14 15 (AR 276). She uses a cane “off & on”, and has been prescribed a back 16 brace, a wrist brace, an elbow brace, and glasses/contacts. (AR 276). 17 18 Plaintiff completed a second Pain Questionnaire, dated March 8, 19 2009, reporting information that is generally consistent with the 20 statements in the first Pain Questionnaire. (See AR 297-300). 21 Plaintiff needs to lie on her side with her knees bent, take medication, 22 use a hot heating pad, and take three baths a day for her pain, which is 23 caused by any movement, including sitting and standing for more than 24 three to five minutes. (AR 297-98). Rest does not relieve her pain 25 because she is not able to lie down or sit for more than ten to fifteen 26 minutes. (AR 297). She is able to stand for ten to fifteen minutes 27 and sit for five minutes at a time before needing to lie down. (AR 28 15 1 299). (Id.). As a result of her pain, she is no longer able to sleep 2 through the night, get dressed without help, do chores, garden, grocery 3 shop alone, drive without an assistant, have a conversation, see 4 friends, finish a sentence, or understand questions asked by others. 5 (AR 298). She drives her own car to the home of her sister or friend 6 down the street and they then drive her to places. (Id.) She is 7 waiting for a breast reduction surgery to help with her back pain, and 8 she is still waiting for a stomach (acid reflux) surgery. (AR 298). 9 10 Plaintiff completed a second Adult Function Report, dated March 8, 11 2009, with the assistance of her husband, in which she reported 12 information that is generally consistent with the statements in the 13 first Adult Function Report and the second Pain Questionnaire. (See AR 14 15 301-08). As a result of her conditions, she can no longer eat, bend to 16 go to the bathroom, walk, go to the grocery store, or communicate 17 without crying. (AR 302). She prepares her own meals (sandwiches, 18 muffins, frozen dinners) twice a week, which takes her three hours. (AR 19 303). She prepares dinner once or twice a week, but needs help 20 finishing. (Id.). She goes outside to try to get mail twice or three 21 times a week, to church once a week, and to the grocery store once a 22 week or once every other week (with her husband, which takes fifteen to 23 twenty minutes). (AR 304). She is able to pay bills and use a 24 checkbook/money orders, but she is not able to count change or handle a 25 savings account. (Id.). She no longer has any hobbies and interests 26 because of her pain, but prior to her conditions she was able to read, 27 paint, ski and sew. (AR 305). Her conditions affect the same abilities 28 16 1 identified in the first Adult Function Report, except for hearing and 2 getting along with others. (AR 306). She can lift five pounds, stand 3 for 10 to 15 minutes, sit for 15 minutes, walk to the mailbox or washer 4 and pay attention for five minutes, but she cannot bend, squat, 5 understand (needs to be told five times), or follow written instructions 6 (cannot focus) or spoken instructions (needs to be told two to three 7 times). (Id.). 8 9 At the October 14, 2010 administrative hearing, Plaintiff testified 10 that she has pain in her shoulders, neck and back, right wrist, and 11 stomach. She has received injections for her shoulders and stomach, and 12 has tried acupuncture, Lexapro patches, Lidoderm3 patches, medication 13 (strong) such as Robaxin (but no longer Vicodin or Talwin), heat packs 14 15 and hot baths for her neck and back. (AR 83-86, 89-91). She has 16 difficulty standing, sitting, turning and sitting on the toilet, (AR 91- 17 92), and difficulty going to sleep because of the pain and staying 18 asleep because of nightmares. (AR 86). On a typical day, she gets up 19 in the morning, tries to make something to eat, sits down for a little 20 (due to fatigue), tries to rinse dishes while sitting on a stool 21 (somebody else loads them), sits down for a little while and starts a 22 load of laundry (her husband carries the basket to the room). (AR 86- 23 87, 90). She dresses herself “most of the time,” but needs assistance 24 with shoes (except for sandals) because she cannot bend over. (AR 90). 25 26 27 3 Lidoderm is a topical analgesic. Fonseca v. Astrue, 2011 WL 28 2412627, *4 (C.D. June 10, 2011). 17 1 At the administrative hearing on September 6, 2012, Plaintiff 2 testified that her typical activities include driving to the grocery 3 store once a week where she spends fifteen to twenty minutes to shop, 4 going to the hairdresser once a month, and to doctors’ appointments. 5 For about four months, she has volunteered, with two other teachers, 6 monitoring crafts projects for twelve children in a classroom at church 7 twice a month for about an hour. She goes to church services twice a 8 month and attends women’s Bible study at the church once a month. She is 9 able to shower but cannot take a bath without help, and she is able to 10 sweep, lift maybe four pounds at a time, and sit for fifteen to twenty 11 minutes before needing to change positions. (AR 37-38, 44-49, 54). She 12 spends two to three “bad days” a week lying down, but most of the time 13 she alternates between sitting and standing. (AR 62-63). Any kind of 14 15 work, even simple work, would have caused her stress, because she 16 worried about where the bathroom was and about “being able to get up and 17 move.” (AR 58). Although she experiences stress around other people, 18 she attends church and Bible study because they are “like a safe haven 19 [] because [she] know[s] they’re not out there to hurt [her].” (AR 59- 20 60). She was not able to balance a checkbook and pay bills due to 21 difficulty concentrating and stress from worrying about lack of money. 22 (AR 61). Her irritable bowel syndrome causes her to have bowel movement 23 accidents. The medication she takes for irritable bowel syndrome does 24 not work. (AR 52). She takes Xanax and Lexapro for psychological 25 issues, and uses Lidoderm patches for back pain. (AR 50-51). 26 27 28 18 1 At the May 27, 2016 administrative hearing, Plaintiff testified 2 that she still has pain in her neck, middle and lower back, right 3 shoulder, right knee, right wrist, and migraine headaches (once a week), 4 and her pain is at the same level she experienced during the earlier 5 hearings. (AR 890-91, 896-97). To relieve the pain, she sits down and 6 reclines with pillows behind her and her feet on a chair; she gets up 7 more and lies down less because lying down is “more painful.” (AR 892- 8 93). She tried physical therapy to treat the pain and she now treats 9 her pain by seeing a chiropractor two times a week, taking a two-hour 10 bath every day, and taking prescription medications. (AR 891, 893). 11 She is “on the list” for breast reduction surgery to ease her back pain. 12 (AR 891). She can sit or stand for fifteen to twenty minutes. (AR 893- 13 94). She tries to do chores such as loading the washer and dryer once 14 15 a week (her husband finishes the job). (AR 894). She still has issues 16 with depression in “certain situations,” but her depression is not as 17 bad as when she was seeing a psychologist (Dr. Flores). (AR 895-96). 18 Although she has a cane, she tries not to use it because she wants to be 19 “independent.” (AR 899). While she still has issues with irritable 20 bowel syndrome, she has not had any accidents in the car. (AR 896-97). 21 22 At the administrative hearing on January 16, 2019, Plaintiff 23 testified she still experienced the same problems she had at the time of 24 the earlier hearings. (AR 1352-53). 25 26 // 27 // 28 19 1 2. The ALJ’s Credibility Findings 2 3 After summarizing Plaintiff’s testimony (see AR 1327-28), ALJ Arno 4 found Plaintiff’s testimony about the intensity, persistence and 5 limiting effects of her pain and symptoms to be inconsistent with her 6 activities of daily living, the objective medical evidence, and the 7 frequency or extent of treatment. (See AR 1328-29). 8 9 ALJ Arno observed that the physical and mental abilities and the 10 social interactions required for Plaintiff to perform normal activities 11 of daily living, such as preparing meals, rinsing dishes, loading 12 laundry, sometimes sweeping, driving a car, attending church and Bible 13 study, and volunteering at church, are the same as those necessary for 14 15 obtaining and maintaining employment. ALJ Arno further observed that 16 such daily activities were inconsistent with Plaintiff’s complaints 17 about her difficulties sitting, standing, walking, lifting, squatting, 18 kneeling, understanding, concentrating, getting along with others, and 19 completing tasks because they suggest a higher level of functioning than 20 Plaintiff alleged. Therefore, ALJ Arno found Plaintiff’s ability to 21 participate in such activities to be inconsistent with her statements 22 concerning the alleged intensity, persistence, and limiting effects of 23 her symptoms. (AR 1328-29). 24 25 ALJ Arno also found Plaintiff’s statements regarding the alleged 26 intensity, persistence, and limiting effects of her symptoms to be 27 inconsistent with the objective medical evidence regarding the duration 28 and frequency of her symptoms. (AR 1329). For example, ALJ Arno pointed 1 out that while Plaintiff claimed to be suffering from debilitating pain 2 from her disability onset date to the date last insured, reports of 3 physical examinations in November 2004 and May 2009 revealed that 4 Plaintiff was “in no acute distress,” exhibited full muscle strength in 5 her upper and lower extremities and greater range of motion, and was 6 able to squat without difficulty and walk with stability. (AR 579, 758). 7 8 In addition, ALJ Arno observed that the degree of Plaintiff’s 9 subjective complaints was not comparable to the limited and conservative 10 nature of the treatment Plaintiff received and the lack of any 11 explanation for not seeking more extensive or aggressive treatment 12 options. Therefore, ALJ Arno found Plaintiff’s statements concerning 13 the alleged intensity, persistence and limiting effects of symptoms to 14 15 be inconsistent with the treatment she received. (AR 1329). 16 17 After addressing the medical evidence and the opinions of the 18 medical expert (Sami A. Nafoosi, M.D.), Plaintiff’s treating physicians 19 (James F. Lineback, M.D., Chirag N. Amin, M.D., and Matthey Huey, M.D.), 20 the medical and psychiatric consultative examiners (Kristof Siciarz, 21 M.D. and Hiruy Gessesse, M.D.) the State Agency medical and 22 psychological consultants (P.N. Ligot, M.D., L.O. Mallare, M.D., G. 23 Johnson, M.D., and M. Abundes-Tienda), Plaintiff’s treating psychologist 24 (Nelson J. Flores, Ph.D), and the testimony by Plaintiff’s husband (see 25 AR 1329-37), ALJ Arno concluded that: 26 27 In sum, the evidence as a whole supports the residual 28 functional capacity assessed by this decision. The claimant’s statements regarding the alleged intensity, persistence, and 1 limiting effects of symptoms are inconsistent with the overall evidence of record and the objective medical evidence does not 2 support the alleged severity of symptoms. I find the claimant has not been deprived of the ability to perform substantial 3 gainful activity subject to the residual functional capacity assessed by this decision for any 12-month period during the 4 relevant period. 5 6 (AR 1337). 7 8 3. Analysis 9 10 As set forth below, ALJ Arno gave clear and convincing reasons, 11 supported by substantial evidence, for finding Plaintiff’s testimony 12 about the intensity, persistence and limiting effects of her pain and 13 symptoms not credible.4 14 ALJ Arno properly determined that Plaintiff’s alleged functional 15 limitations were inconsistent with her ability to perform her activities 16 of daily living, including preparing meals (see AR 45, 86-87, 270, 272, 17 299, 303, 308), rinsing dishes (see AR 45, 87, 90, 269-70, 301), loading 18 laundry (see AR 45, 87, 269-70, 299, 301, 303, 894), sometimes sweeping 19 20 4 To the extent that Defendant contends that the Court should not apply a “clear and convincing” standard based on evidence in the 21 record that Plaintiff was malingering (see Joint Stip. at 26-27), the Court declines to do so. ALJ Arno did not make a specific finding that 22 Plaintiff was malingering. See Robbins, 466 F.3d at 883; see also Garrison, 759 F.3d at 1010 (“We review only the reasons provided by the 23 ALJ in the disability determination and may not affirm the ALJ on a ground upon which he did not rely.”); Connett v. Barnhart, 340 F.3d 871, 24 874 (9th Cir. 2003)(“We are constrained to review the reasons the ALJ asserts.”; citing SEC v. Chenery Corp., 332 U.S. 194, 196 (1947) and 25 Pinto v. Massanari, 249 F.3d 840, 847-48 (9th Cir. 2001)). 26 Likewise, the Court will not consider Defendant’s arguments that ALJ Arno properly discredited Plaintiff’s testimony based on 27 Plaintiff’s failure to follow up with treatment and the improvement of Plaintiff’s impairments with treatment (see Joint Stip. at 31), since 28 ALJ Arno did not provide those reasons in the decision. 1 (see AR 46), driving a car (see AR 37-38, 269, 273, 299), attending 2 church and Bible study (see AR 46-47, 60, 274, 305), volunteering at 3 church (see AR 44-45), and grocery shopping (see AR 38, 273, 299, 303- 4 04). See 20 C.F.R. § 404.1529(c)(3)(1) (a claimant’s daily activities 5 are one factor to be considered in evaluating a claimant’s symptoms, 6 such as pain). Plaintiff’s ability to engage in such activities, even 7 if she sometimes needed assistance and/or breaks (see AR 38, 45, 87, 8 268-70, 272, 274, 299, 301, 303-05, 308, 894), rendered Plaintiff’s 9 testimony that she spent most of the day lying down and essentially 10 unable to do anything (see AR 48-50, 63, 66-67, 86-93, 268-77, 297-99, 11 301-08, 892-94) not credible. See Ghanim, 763 F.3d at 1165 (“Engaging 12 in daily activities that are incompatible with the severity of symptoms 13 alleged can support an adverse credibility determination.”); Molina v. 14 15 Astrue, 674 F.3d 1104, 1113 (9th Cir. 2012)(“[T]he ALJ may discredit a 16 claimant’s testimony when the claimant reports participation in everyday 17 activities indicating capacities that are transferable to a work 18 setting;” “Even where those activities suggest some difficulty 19 functioning, they may be grounds for discrediting the claimant’s 20 testimony to the extent that they contradict claims of a totally 21 debilitating impairment.”); and Morgan v. Comm’r of Soc. Sec. Admin., 22 169 F.3d 595, 600 (9th Cir. 1999)(“If a claimant is able to spend a 23 substantial part of his day engaged in pursuits involving the 24 performance of physical functions that are transferable to a work 25 setting, a specific finding as to this fact may be sufficient to 26 discredit a claimant's allegations.”); see also Burch v. Barnhart, 400 27 F.3d 676, 680-81 (9th Cir. 2005)(claimant’s allegations of disability 28 properly discredited where claimant was able to care for her own 1 personal needs, cook, clean, shop, interact with her nephew and 2 boyfriend, and manage finances). 3 4 ALJ Arno properly discounted Plaintiff’s testimony about the 5 alleged intensity, persistence and limiting effects of her symptoms 6 based on inconsistencies between Plaintiff’s reported ability to perform 7 such daily activities, even if assistance and/or breaks were sometimes 8 needed, and her testimony about her severe difficulties with sitting, 9 standing, walking, lifting, squatting, kneeling, understanding, 10 concentrating, getting along with others, and completing tasks (see AR 11 48-50, 54, 267-72, 275, 297-99, 301, 303, 305-06, 896). See Burrell v. 12 Colvin, 775 F.3d 1133, 1138-39 (9th Cir. 2014)(“Inconsistencies between 13 a claimant’s testimony and the claimant’s reported activities provides 14 15 a valid reason for an adverse credibility determination.”; citing Light 16 v. Social Security Admin., 119 F.3d 789, 792 (9th Cir. 1997). 17 18 ALJ Arno properly found that Plaintiff’s testimony about the 19 intensity, persistence and limiting effects of her pain and symptoms was 20 not supported by the objective medical evidence (see AR 1329). See 21 Burch, 400 F.3d at 681 (“Although lack of medical evidence cannot form 22 the sole basis for discounting pain testimony, it is a factor that the 23 ALJ can consider in his credibility analysis.”); Rollins, 261 F.3d at 24 857 (“While subjective pain testimony cannot be rejected on the sole 25 ground that it is not fully corroborated by objective medical evidence, 26 the medical evidence is still a relevant factor in determining the 27 severity of the claimant’s pain and its disabling effects.”); SSR 16-3p, 28 *5 (“objective medical evidence is a useful indicator to help make 1 reasonable conclusions about the intensity and persistence of symptoms, 2 including the effects those symptoms may have on the ability to perform 3 work-related activities”). 4 5 As the ALJ noted, the objective evidence in the record conflicted 6 with Plaintiff’s testimony about her symptoms and functional 7 limitations. See 20 C.F.R. § 404.1529(c)(2) (“Objective medical 8 evidence . . . is a useful indicator to assist us in making reasonable 9 conclusions about the intensity and persistence of your symptoms and the 10 effect those symptoms, such as pain, may have on your ability to 11 work.”). Such evidence included (1) a physical examination on November 12 2, 2004, reporting that Plaintiff was alert and in no acute distress, 13 walked with a normal gait, had full muscle strength in her lower 14 15 extremities, could perform tip-toe and heel walking without weakness, 16 and could squat without difficulty (see AR 577-81); (2) a physical 17 examination on November 15, 2008, reporting that Plaintiff had normal 18 movements, did not use an assistive device for ambulation, was able to 19 sit comfortably without shifting, stand from a sitting position and sit 20 up from the supine position without difficulty, showed ranges of motion 21 in the upper and lower extremities within normal limits, did not have 22 pain upon palpation along the paraverterbral area, had a negative 23 bilateral straight-leg raising test, and had normal motor strength, 24 muscle tone, coordination, gait and station (see AR 518-20); (3) a 25 physical examination on June 23, 2009, noting that, although Plaintiff 26 had limited range of motion in the neck and right upper extremity, 27 Plaintiff had a stable gait, stable heel and toe walking, normal 28 station, “walk[ed] with greater flexion that she exhibited on specific 1 lumbar [range of motion] testing,” and had a negative straight-leg 2 raising test (see AR 756-59); (4) an x-ray of the right shoulder August 3 20, 2009, revealed no fracture or joint subluxation, normal alignment, 4 and no degenerative changes (see AR 763-64); (5) a physical examination 5 on September 4, 2009, noted that, although Plaintiff had limited range 6 of motion in the neck and upper extremities, Plaintiff had stable gait 7 and heel and toe walking (see AR 771-73); (6) an MRI of the cervical 8 spine on September 18, 2009, showed mild reversal of normal lordosis and 9 mild degenerative changes (see AR 774); (7) a physical examination on 10 October 1, 2009, revealed, inter alia, that Plaintiff’s neck was supple 11 and showed a full range of motion without pain and that Plaintiff was 12 alert and oriented and used normal speech (see AR 777-80); and (8) a 13 physical examination on March 10, 2010, revealed, inter alia, that 14 15 Plaintiff had “[m]ild apparent stress” and was alert, and that, although 16 Plaintiff had limited range of motion in the neck and upper extremities, 17 Plaintiff had stable, slow gait, stable heel and toe walking, normal 18 station, and a negative straight leg-raising (see AR 792-95). While 19 Plaintiff may interpret the medical record differently, the Court cannot 20 conclude that ALJ Arno’s interpretation of the medical record was 21 irrational. Burch, 400 F.3d at 679 (“Where evidence is susceptible to 22 more than one rational interpretation, it is the ALJ’s conclusion that 23 must be upheld.”). 24 25 ALJ Arno also properly found that Plaintiff’s testimony about the 26 limiting effects of her symptoms was not supported by the conservative 27 nature of her treatment. As ALJ Arno noted, Plaintiff testified her 28 treatment consisted of only physical therapy, acupuncture, injections, 1 Lexapro patches, prescription medications (none of which were heavy-duty 2 narcotics), heat packs, and hot baths (see AR 50-51, 84-86, 267, 891- 3 93). See Parra v. Astrue, 481 F.3d 742, 750-51 (9th Cir. 2007)(“The ALJ 4 also noted that [the claimant’s] physical ailments were treated with 5 over-the-counter pain medication. We have previously indicated that 6 evidence of ‘conservative treatment’ is sufficient to discount a 7 claimant’s testimony regarding severity of an impairment.”; citation 8 omitted); Johnson v. Shalala, 60 F.3d 1428, 1434 (9th Cir. 1995)(an ALJ 9 may properly rely on the fact that prescribed conservative treatment 10 suggests a lower level of both pain and functional limitation); see also 11 Meanel v. Apfel, 172 F.3d 1111, 1113 (9th Cir. 1999)(“[The claimant’s] 12 claim that she experienced pain approaching the highest level imaginable 13 was inconsistent with the ‘minimal, conservative treatment’ that she 14 15 received.”]). 16 17 The ALJ’s reasons for discounting Plaintiff’s testimony about the 18 limiting effects of her pain and symptoms -- inconsistency with 19 activities of daily living, the lack of support in the medical record, 20 and a conservative course of treatment -- were specific, clear and 21 convincing. 22 23

B. ALJ Arno Provided Germane Reasons for Rejecting Plaintiff’s

24 Husband’s Testimony 25 26 The ALJ is required to give germane reasons for rejecting or 27 partially rejecting lay witness testimony. See Carmickle v. Comm’r v. 28 Soc. Sec. Admin., 533 F.3d 1155, 1162–63 (9th Cir. 2008); Greger v. 1 Barnhart, 464 F.3d 968, 972 (9th Cir. 2006); Lewis v. Apfel, 236 F.3d 2 503, 511 (9th Cir. 2001); Smolen, 80 F.3d at 1288-89. 3 4 Plaintiff’s husband completed Adult Third Party Function Reports 5 dated September 4, 2008 and March 8, 2009, which essentially mirror, 6 with less detail, the allegations Plaintiff made in her Pain 7 Questionnaires and Function Reports. (See AR 259-66, 289-96). 8 9 After briefly summarizing the statements by Plaintiff’s husband, 10 (see AR 1336 [“In these third party function reports, he indicated that 11 the claimant required assistance to perform chores. Further, these 12 opinions alleged the claimant was only able to walk for short distances 13 and drive when she felt well[.]”]), ALJ Arno made the following 14 15 assessment of his testimony: 16 17 These opinions, however, reflect the limitations expressed in the claimant’s testimony, which the undersigned 18 has found to be inconsistent with the overall evidence of record. Moreover, the undersigned discounts these opinions 19 because they inconsistently noted that the claimant was able to perform several activities of daily living, such as driving 20 herself to run various errands and perform household tasks like cooking meals and washing dishes, albeit with breaks or 21 while seated. In addition, while a layperson can offer an opinion on a diagnosis, the severity of the claimant’s 22 symptoms, or the side effects of medications in relationship to the claimant’s ability to work, the opinion of a layperson 23 is far less persuasive on those same issues than are the opinions of medical professionals as relied on herein. Most 24 important, these opinions are not supported by the clinical or 25 diagnostic medical evidence that is discussed elsewhere in this decision. For example, these opinions are inconsistent 26 with evidence suggesting that on examination the claimant has been observed as “alert” and “in no acute distress.” Further, 27 she has exhibited full muscle strength in her upper and lower extremities ([AR 579]). Additionally, she has been observed 28 to squat without difficulty and walk stably with “greater flexion tha[n] she exhibited on specific lumbar [range of motion] testing” ([AR 758). Accordingly, based on the above 1 specific reasons, the undersigned assigns partial weight to this opinion. 2 (AR 1336-37). 3 4 5 Since ALJ Arno provided clear and convincing reasons for finding 6 Plaintiff’s statements about her functional limitations not credible, 7 her determination that the similar statements made by Plaintiff’s 8 husband were only entitled to partial weight was a germane reason for 9 discounting Plaintiff’s husband’s testimony. See Valentine v. 10 Commissioner, 574 F.3d 685, 694 (9th Cir. 2009)(“In light of our 11 conclusion that the ALJ provided clear and convincing reasons for 12 rejecting [the claimant’s] own subjective complaints, and because [the 13 claimant’s wife’s] testimony was similar to such complaints, it follows 14 that the ALJ also gave germane reasons for rejecting [the claimant’s 15 wife’s] testimony.”). 16 17 Moreover, ALJ Arno’s determination that Plaintiff’s husband’s 18 testimony was not supported by the objective medical evidence (discussed 19 above) was a germane reason for finding that his testimony lacked 20 credibility. See Bayliss v. Barnhart, 427 F.3d 1211, 1218 (9th Cir. 21 2015)(inconsistency with the medical evidence is a germane reason for 22 discrediting the testimony of a lay witness); Lewis, 236 F.3d at 511 23 (“One reason for which an ALJ may discount lay testimony is that it 24 25 conflicts with medical evidence.”); Vincent v. Heckler, 739 F.2d 1393, 26 1395 (9th Cir. 1984)(“The ALJ properly discounted lay witness testimony 27 that conflicted with the available medical evidence.”). 28 29 1 Accordingly, ALJ Arno provided germane reasons for partially 2 rejecting Plaintiff’s husband’s testimony. 3 4

C. ALJ Arno Properly Assessed the Opinions of Plaintiff’s Treating

5 Physicians and Psychologist 6 7 Plaintiff asserts that ALJ Arno failed to properly assess the 8 opinions of her treating physicians, Drs. Amin and Lineback, and her 9 treating psychologist, Dr. Flores. (See Joint Stip. at 8-14).5 10 Defendant asserts that ALJ Arno properly evaluated Dr. Amin’s, Dr. 11 Lineback’s and Dr. Flores’s opinions. (See Joint Stip. at 15-22). 12 13 An ALJ must take into account all medical opinions of record. 20 14 15 C.F.R. § 404.1527(b).6 “Generally, a treating physician’s opinion 16 carries more weight than an examining physician’s, and an examining 17 physician’s opinion carries more weight than a reviewing physician’s.” 18 Holohan v. Massanari, 246 F.3d 1195, 1202 (9th Cir. 2001); see also 19 5 Since Plaintiff’s claim solely challenges ALJ Arno’s 20 evaluation of the opinions of Drs. Amin, Lineback and Flores, the Court will not discuss ALJ Arno’s evaluation of the opinions of the medical 21 expert (Dr. Nafoosi), Plaintiff’s other treating physician (Dr. Huey), the consultative medical examiner (Dr. Siciarz), the State Agency 22 medical consultants (Drs. Ligot and Mallare), the psychiatric consultative examiner (Dr. Gessessee) and the State Agency psychological 23 consultants (Dr. Johnson and Ms. Abundes-Tienda) 24 6 Since Plaintiff filed her application before March 27, 2017, 20 C.F.R. § 404.1527 applies. For an application filed on or after 25 March 27, 2017, 20 C.F.R. § 404.1520c would apply. 20 C.F.R. § 404.1520c changed how the Social Security Administration considers 26 medical opinions and prior administrative medical findings, eliminated the use of the term “treating source,” and eliminated deference to 27 treating source medical opinions. See 20 C.F.R. § 404.1520c(a); L.R. v. Saul, 2020 WL 264583, at *3 n. 5 (C.D. Cal. Jan. 17, 2020); see also 81 28 Fed. Reg. 62560, at 62573-74 (Sept. 9, 2016). 30 1 Lester v. Chater, 81 F.3d 821, 830-31 (9th Cir. 1995). The medical 2 opinion of a treating physician is given “controlling weight” so long as 3 it “is well-supported by medically acceptable clinical and laboratory 4 diagnostic techniques and is not inconsistent with the other substantial 5 evidence in [the claimant’s] case record.” 20 C.F.R. § 404.1527(c)(2). 6 “When a treating doctor’s opinion is not controlling, it is weighted 7 according to factors such as the length of the treatment relationship 8 and the frequency of examination, the nature and extent of the treatment 9 relationship, supportability, and consistency of the record.” Revels 10 v. Berryhill, 874 F.3d at 654; see also 20 C.F.R. § 404.1527(c)(2)-(6). 11 12 If a treating or examining doctor’s opinion is not contradicted by 13 another doctor, the ALJ can reject the opinion only for “clear and 14 15 convincing reasons.” Carmickle v. Commissioner, 533 F.3d 1155, 1164 16 (9th Cir 2008); Lester, 81 F.3d at 830. If the treating or examining 17 doctor’s opinion is contradicted by another doctor, the ALJ must provide 18 “specific and legitimate reasons” that are supported by substantial 19 evidence in the record for rejecting the opinion. Orn v. Astrue, 495 20 F.3d 625, 632 (9th Cir. 2007); Reddick v. Chater, 157 F.3d 715, 725 (9th 21 Cir. 1998); Lester, supra. “The ALJ can meet this burden by setting out 22 a detailed and thorough summary of the facts and conflicting clinical 23 evidence, stating his interpretation thereof, and making findings.” 24 Trevizo v. Berryhill, 871 F.3d 664, 675 (9th Cir. 2017)(citation 25 omitted). Finally, an ALJ may reject an opinion of any physician that 26 is conclusory, brief, and unsupported by clinical findings. Bayliss v. 27 Barnhart, 427 F.3d 1211, 1216 (9th Cir. 2015); Thomas v. Barnhart, 278 28 31 1 F.3d 947, 957 (9th Cir. 2002); Tonapetyan v. Halter, 242 F.3d 1144, 1149 2 (9th Cir. 2001). 3 4 1. Dr. Amin 5 6 Dr. Amin, an orthopedic surgeon and Plaintiff’s treating physician 7 in connection with her California Workers’ Compensation case, completed 8 an Initial Comprehensive Orthopedic Report following an examination of 9 Plaintiff on November 2, 2004. (See AR 574-86). Plaintiff complained 10 of neck, middle and lower back pain, right hand and wrist pain, numbness 11 and tingling in her right hand and fingers, and “[s]ymptoms of 12 depression, anxiety and insomnia, secondary to her alleged hostile work 13 environment[.]” (AR 576). Dr. Amin diagnosed Plaintiff with 14 15 “[c]ervical and lumbrosacral sprain/strain with myofascitis,” 16 “[t]horacic myofascitis,” “[d]epression [secondary to alleged hostile 17 work environment],” and “[s]prain/strain, right wrist,” (AR 581), and 18 opined that Plaintiff was “temporarily totally disabled” (“TTD”) for 6 19 weeks. (AR 582). 20 21 From January 11, 2005 to August 23, 2005, Dr. Amin completed four 22 Progress Reports. Based on Plaintiff’s complaints, physical 23 examinations, the results of electrodiagnostic studies of the bilateral 24 upper and lower extremities, x-rays of the right hand, lumbar spine, 25 thoracic spine and cervical spine, and the same diagnoses as those in 26 the Initial Comprehensive Orthopedic Report, Dr. Amin opined that 27 28 32 1 Plaintiff was TTD from January 11, 2005 through October 1, 2005. (AR 2 627-30). 3 4 ALJ Arno gave “little weight” to Dr. Amin’s opinion that Plaintiff 5 was TTD for approximately an 11-month period, finding that: (a) TTD was 6 a Workers’ Compensation law term of art (indicating that for a certain 7 period a person is unable to return to the job being performed at the 8 time of the injury) that was not “directly relevant” under Social 9 Security law because there is a different criteria for a finding of 10 disability, (b) Dr. Amin’s opinion was not inconsistent with ALJ Arno’s 11 RFC determination which precludes Plaintiff from performing the work she 12 was performing at the time of her Workers’ Compensation injury, and (c) 13 Dr. Amin did not identify any specific functional work limitations. 14 15 (See AR 1333-34). 16 17 ALJ Arno properly noted that Dr. Amin’s opinion that Plaintiff was 18 TTD was specific to Plaintiff’s Workers’ Compensation claim and not 19 binding on a determination about whether Plaintiff was disabled in this 20 case. See 20 C.F.R. §§ 404.1504 (“Other governmental agencies and 21 nongovernmental entities . . . make disability, blindness, 22 employability, Medicaid, workers’ compensation, and other benefits 23 decisions for their own programs using their own rules. [Such decisions 24 are]. . . not binding on us and is not our decision about whether you 25 are disabled or blind under our rules.”); Alvarez v. Colvin, 562 26 Fed.Appx. 553, 553 (9th Cir. 2014)(“Because the ALJ is obliged to make 27 a disability determination based on social security law, the ALJ was not 28 33 1 bound by Dr. Larsen’s finding that [the claimant] was temporarily 2 totally disabled for purposes of California workers’ compensation”); see 3 also 20 C.F.R. §§ 404.1527(c)(6) (“[T]he amount of understanding of our 4 disability programs and their evidentiary requirements that an 5 acceptable medical source has . . . are relevant factors that we will 6 consider in deciding the weight to give to a medical opinion.”), 7 404.1527(d)(1)(“A statement by a medical source that you are ‘disabled’ 8 or ‘unable to work’ does not mean that we will determine that you are 9 disabled.”); Baroni v. Astrue, 2011 WL 2939405, *5 (C.D. Cal. July 18, 10 2011)(“The Court concurs with the ALJ that conclusory statements like 11 those made by Dr. Haq in his February 26, 2003 Workers’ Compensation 12 report are not probative of whether a claimant is disabled from engaging 13 in any substantial gainful activity or probative of a claimant's 14 15 functional limitations.”). 16 17 Moreover, ALJ Arno did not simply disregard Dr. Amin’s opinion 18 solely because it was generated in a Workers’ Compensation matter, which 19 would be improper. See Booth v. Barnhart, 181 F.Supp.2d 1099, 1105-06 20 (C.D. Cal. 2002)(“The ALJ may not disregard a physician’s medical 21 opinion simply because it was initially elicited in a state workers’ 22 compensation proceeding, or because it is couched in the terminology 23 used in such proceedings.”; “[T]he ALJ must evaluate medical opinions 24 couched in state workers’ compensation terminology just as he or she 25 would evaluate any other medical opinion.”; “The ALJ must ‘translate’ 26 terms of art contained in such medical opinions into the corresponding 27 Social Security terminology in order to accurately assess the 28 34 1 implications of those opinions for the Social Security disability 2 determination.”; and “While the ALJ’s decision need not contain an 3 explicit ‘translation,’ it should at least indicate that the ALJ 4 recognized the differences between the relevant state workers’ 5 compensation terminology, on the one hand, and the relevant Social 6 Security disability terminology, on the other hand, and took those 7 differences into account in evaluating the medical evidence.”; citations 8 omitted); see also Lester v. Chater, 81 F.3d 821, 832 (9th Cir. 1995)(as 9 amended)(“The purpose for which medical reports are obtained does not 10 provide a legitimate basis for rejecting them.”). Rather, ALJ Arno 11 found that Dr. Amin’s opinion was not necessarily inconsistent with ALJ 12 Arno’s Step Four finding that Plaintiff was unable to perform any past 13 relevant work (AR 1337). 14 15 16 Finally, ALJ Arno properly found that Dr. Amin’s opinion was 17 entitled to less weight because Dr. Amin did not provide or identify any 18 specific functional work limitations that would assist in the RFC 19 determination. See Meanel v. Apfel, 172 F.3d 1111, 1114 (9th Cir. 20 1999)(noting that a treating physician must make “specific findings that 21 [are] useful in the disability determination”); 20 C.F.R. § 22 404.1527(a)(1) (“Medical opinions are statements from acceptable medical 23 sources that reflect judgments about the nature and severity of your 24 impairment(s), including your symptoms, diagnosis and prognosis, what 25 you can still do despite impairment(s), and your physical or mental 26 restrictions.”; emphasis added); see also 20 C.F.R. § 404.1545(a)(1) 27 (“Your impairment(s), and any related symptoms, such as pain, may cause 28 35 1 physical and mental limitations that affect what you can do in a work 2 setting. Your residual functional capacity is the most you can still do 3 despite your limitations.”). 4 5 Thus, the ALJ provided clear and convincing and/or specific and 6 legitimate reasons for rejecting Dr. Amin’s opinion. 7

8 2. Dr. Lineback 9 10 Dr. Lineback, who is Board Certified in Internal Medicine and 11 Pulmonary Medicine, examined Plaintiff in connection with her Workers’ 12 Compensation claim on February 15, 2005. On February 18, 2005, Dr. 13 Lineback completed a Report in which he opined, inter alia, that 14 15 Plaintiff “will require a preclusion from emotional distress to avoid 16 any further aggravation of her gastrointestinal complaints due to 17 gastric hyperacidity and irritable bowel syndrome.” (See AR 617-25). 18 19 ALJ Arno gave “partial weight” to Dr. Lineback’s opinion. (AR 20 1333). While acknowledging that Dr. Lineback reasonably found a 21 connection between emotional stress and [Plaintiff’s] gastrointestinal 22 complaints, ALJ Arno found that Dr. Lineback’s opinion was not entitled 23 to more weight to because “what might cause emotional distress could 24 differ on a case by case basis” and “Dr. Lineback did not specify what 25 should be precluded or the most [Plaintiff] was capable of despite the 26 impairments.” (Id.). ALJ Arno stated that the RFC determination 27 limiting Plaintiff to simple and routine tasks that require only simple 28 36 1 decisions and precluding Plaintiff from work requiring a high-quota 2 production-rate pace, (see AR 1327), sufficiently addressed stress 3 caused by workload in the workplace. (Id.). 4 5 ALJ Arno properly assessed partial weight to Dr. Lineback’s opinion 6 because of his failure to specify what Plaintiff should be precluded 7 from doing in the workplace or what Plaintiff was capable of doing in 8 the workplace despite her impairments. See Meanel, 172 F.3d at 1114; 9 20 C.F.R. § 404.1527(a)(1). As Defendant asserts (see Joint Stip. at 10 19), Plaintiff has failed to allege how ALJ Arno’s RFC determination, 11 which also limited Plaintiff to only occasional contact with the public 12 and occasional interaction with coworkers (AR 1327), did not 13 sufficiently accommodate Plaintiff’s need to avoid workplace stress. 14 15 See Sherman v. Colvin, 582 Fed.Appx. 745, 748 (9th Cir. 2014)(affirming 16 ALJ’s rejection of treating physicians’ opinions based on claimant’s 17 failure to show how RFC was inconsistent with treating physicians’ 18 opinions). 19 20 Therefore, ALJ Arno’s reasons for rejecting Dr. Lineback’s opinion 21 were clear and convincing and/or specific and legitimate. 22 23 3. Dr. Flores 24 25 Nelson J. Flores, Ph.D., a psychologist, treated Plaintiff in 26 connection with her Worker’s Compensation claim from December 9, 2004, 27 to January 11, 2008, (See AR 589-93 [Psychological Testing Report dated 28 37 1 December 16, 2004], 596-697 [Psychological Medical-Legal Consultation 2 Report dated January 13, 2005], 398-413 [Progress Reports dated March 9, 3 21, 2005, May 22, 2005, July 13, 2005, October 4, 19, 2005, November 15, 4 23, 2005, January 23, 2006, an undecipherable date in February 2006, 5 March 7, 2006, April 9, 2006 (erroneously written as 2008), and May 31, 6 2006], 414-40 [Comprehensive Psychological Medical-Legal Permanent and 7 Stationary Evaluation Report dated September 5, 2006], 441-56 [Progress 8 Reports dated November 17, 2006, January 19, 2007, March 2, 2007, May 4, 9 2007, May 28, 2007, October 4, 2007, November 16, 2007, and January 18, 10 2008]). 11 12 On January 13, 2005, Dr. Flores completed a Psychological Medical- 13 Legal Consultation Report following his examination of Plaintiff and 14 15 review of the Psychological Testing Report dated December 16, 2004 (see 16 AR 589-93). (See AR 596-607). Plaintiff complained of difficulty 17 sleeping, nervousness, restlessness, headaches, chest discomfort, muscle 18 tension, weakness throughout her body and in her legs, hot sensations 19 over her body, trembling hands, body shakiness, unsteadiness, feeling 20 fearful, heart pounding, nausea, indigestion, acid reflux, irritable 21 bowel syndrome, constipation, diarrhea, low energy, sadness, 22 irritability, difficulty controlling emotions and impulses, crying, 23 difficulty concentrating and remembering, inability to relax, fears of 24 the worst happening and of losing control, difficulty making decisions, 25 socially withdrawn, inability to feel joy, and decreased sexual desire. 26 (AR 601-02). Mental status examination revealed, inter alia, that 27 Plaintiff was alert and oriented to time, place and person, Plaintiff’s 28 38 1 affect was appropriate to thought content, thought processes were 2 appropriate, logical and coherent, Plaintiff used normal speech and 3 language, Plaintiff’s “concentration was deficient during the 4 evaluation,” Plaintiff had “difficulty remembering recent dates, events 5 and order of events,” and Plaintiff had good insight and judgment. (AR 6 602-03).7 Dr. Flores diagnosed Plaintiff with, inter alia, “major 7 depressive disorder, single episode, mild; generalized anxiety disorder; 8 and psychological factors affecting medical condition, irritable bowel 9 syndrome.” (AR 603). Dr. Flores opined that more than 51% of 10 Plaintiff’s anxiety and depressive disorders and her current 11 psychological disability were directly related to her exposure to stress 12 and sexual harassment commencing on or about 2001, her work overload 13 commencing on or about February 2004, and the orthopedic injuries she 14 15 sustained at work on July 15, 2004. (AR 605). While Dr. Flores 16 provided treatment recommendations, Dr. Flores did not provide or 17 specify any functional work limitations. (See AR 605-06). 18 19 Dr. Flores opined, in Progress Notes prepared in February, March, 20 April, and May, 2006, that Plaintiff should “[r]emain off-work until 21 next appt.” (AR 408-13). Following his examination of Plaintiff, (see 22 AR 414-40), Dr. Flores completed a Comprehensive Psychological Medical- 23 Legal Permanent and Stationary Evaluation Report dated September 5, 24 25 7 In the “Summary and Discussion” section of the December 16, 2004 Psychological Report, Dr. Flores wrote: “The patient’s attention, 26 auditory memory and concentration appeared to be intact. The patient was alert and there was no indication of brain disorder nor 27 neuropsychological impairment.” (AR 592). The ALJ noted that this portion of the summary appeared to be inconsistent with the results of 28 the mental status evaluation. (AR 1330). 39 1 2006, in which he diagnosed Plaintiff with: “Generalized Anxiety 2 Disorder; Major Depressive Disorder, Single Episode, Mild, stable with 3 medical treatment; Psychological Factors Affecting Medical Condition, 4 Irritable Bowel Syndrome and acid reflux; Sleep Disorder Due to Chronic 5 Pain, Insomnia Type; and Female Hypoactive Sexual Desire Disorder, Due 6 to Chronic Pain, which developed from her exposure to stress and sexual 7 harassment, her continuous orthopedic trauma injury commencing in or 8 about August 2003, and her subsequent industrial accident of July 15, 9 2004, at her place of employment.” (AR 416-17, 429-30). Dr. Flores 10 opined, inter alia, that Plaintiff’s current psychological condition was 11 permanent and stationary, her current level of psychiatric disability 12 was moderate (noting a Global Assessment of Function (“GAF”) score of 13 468), and she is a Qualified Injured Worker in need of vocational 14 15 rehabilitation, but unable to successfully complete a vocational 16 rehabilitation due to her current emotional and cognitive functions and 17 18 8 “A GAF score is a rough estimate of an individual’s psychological, social, and occupational functioning used to reflect the 19 individual’s need for treatment.” Vargas v. Lambert, 159 F.3d 1161, 1164 n.2 (9th Cir. 1998). The GAF includes a scale ranging from 0–100, 20 and indicates a “clinician’s judgment of the individual’s overall level of functioning.” American Psychiatric Association, Diagnostic and 21 Statistical Manual of Mental Disorders 32 (4th ed. text rev. 2000) (hereinafter DSM–IV). According to DSM–IV, a GAF score between 41 and 22 50 describes “serious symptoms” or “any serious impairment in social, occupational, or school functioning.” Id. at 34 “Although GAF scores, 23 standing alone, do not control determinations of whether a person’s mental impairments rise to the level of a disability (or interact with 24 physical impairments to create a disability), they may be a useful measurement.” Garrison, 759 F.3d at 1003 n.4. 25 The Court notes that the DSM-V eliminated the GAF scale. See 26 Olsen v. Comm'r Soc. Sec. Admin, 2016 WL 4770038, at *4 (D. Or. Sept. 12, 2016)(“The DSM–V no longer recommends using GAF scores to measure 27 mental health disorders because of their ‘conceptual lack of clarity . . . and questionable psychometrics in routine practice.’”; quoting 28 DSM–V, 16 (5th ed. 2013))). 40 1 her symptoms at this time. (AR 416-18, 430-34). Dr. Flores found 2 Plaintiff’s prognosis to be guarded because he did not believe her 3 mental condition would significantly improve unless her physical 4 condition significantly improved. (AR 418-34). Dr. Flores recommended, 5 inter alia, that if Plaintiff returns to work “in any capacity” and her 6 symptoms persist, (a) she “should not be placed to work in any position 7 where she might be at a risk of being involved in an industrial accident 8 if she becomes anxious and/or distracted (due to her nervousness, 9 restlessness, difficulty concentrating, memory problems, persisting pain 10 and headaches, difficulty controlling her emotions and impulses and 11 difficulty making decisions), (b) she should not work at high altitudes, 12 and (c) she “should not work in any position where she may be required 13 to handle stress and/or conflicts on a regular basis while interacting 14 15 with the public and/or coworkers.” (AR 434). 16 17 ALJ Arno gave “little weight” to Dr. Flores’s various opinions 18 because they were not helpful to, or not inconsistent with, the RFC 19 determination. (AR 1334-35). 20 21 ALJ Arno properly determined that Dr. Flores’s opinion about 22 Plaintiff’s ability to successfully complete a vocational rehabilitation 23 program - “the process of rebuilding work skills as part of recovering 24 from an injury or illness,” - was not relevant to the RFC determination. 25 (AR 1334). See Meanel, 172 F.3d at 1114; 20 C.F.R. § 404.1527(a)(1). 26 Indeed, Plaintiff has failed to show how Dr. Flores’s opinion about 27 Plaintiff’s inability to successfully complete a vocational 28 41 1 rehabilitation program was inconsistent with ALJ Arno’s RFC 2 determination. See Sherman, 582 Fed.Appx. at 748. 3 4 Dr. Flores’s opinions about Plaintiff’s permanent and stationary 5 mental condition and moderate level of psychiatric disability were based 6 on his assessments of Plaintiff’s abilities including a Description of 7 Work Functions/Vocational Manifestation (“Work Functions document”), and 8 a Permanent and Stationary Psychological Disability (“Psychological 9 Disability document”), in which numerical scores were assigned to 10 Plaintiff’s ability to perform specific work functions, (such as ability 11 to comprehend and follow instructions, perform simple and repetitive 12 tasks, maintain work pace appropriate to given work load, perform 13 complex or varied tasks, relate to other people beyond giving and 14 15 receiving instructions, effectively influence people on a consistent 16 basis, making generalizations, evaluations or decisions without 17 immediate supervision, and accept and carry out responsibility for 18 direction, control and planning), (see AR 436-37), and her levels of 19 impairment relating to these functions were listed as “slight to 20 moderate to moderate,” “moderate,” “moderate to moderate to severe,” and 21 “moderate to severe,” (see AR 438-40). 22 23 As ALJ Arno noted (see AR 1334-35), Dr. Flores’s assessments of 24 Plaintiff’s abilities were problematic and/or confusing: (a) the scale 25 provided in the Work Functions document contained a “4" for “moderate 26 (marked impairment),” (AR 436), whereas the terms “moderate” and 27 “marked” have specific definitions in the context of evaluating mental 28 42 1 impairments in Social Security disability cases (see 20 C.F.R. § 404, 2 Subpart P, Appendix 1, Listing of Impairments 12.00F2, 12.04, 12.06); 3 (b) in the Work Functions document, Plaintiff received a “5” (meaning, 4 “severe [unable to perform work function]”) for the sub-area of “React 5 appropriately to criticism from a supervisor,” the only “5" she 6 received, but there was no explanation regarding why she received that 7 score (see AR 437); and (c) in the Psychological Disability document, 8 the terms “slight,” “moderate” and “severe” were not defined, and the 9 highest level of impairment assigned to a work function, namely, 10 “moderate to severe,” which was assigned to Plaintiff’s ability to 11 relate to other people beyond giving and receiving instructions (AR 43), 12 was not clearly defined. 13 14 15 ALJ Arno properly found that the lack of clear definitions for such 16 terms rendered Dr. Flores’s opinions about Plaintiff’s abilities 17 unhelpful to the RFC determination. See Ford v. Saul, 950 F.3d 1141, 18 1156 (9th Cir. 2020)(“[T]he ALJ determined that Dr. Zipperman did not 19 provide useful statements regarding the degree of [the claimant’s] 20 limitations. Here, the ALJ found that Dr. Zipperman’s descriptions of 21 [the claimant’s] ability to perform in the workplace as “limited” or 22 “fair” were not useful because they failed to specify [“the claimant’s] 23 functional limits. Therefore, the ALJ could reasonably conclude these 24 characterizations were inadequate for determining RFC.”). ALJ Arno also 25 properly found that the numerical scores given to specific abilities on 26 the Work Functions Report were not adequately explained or supported. 27 See Ford, 950 F.3d at 1155 (“An ALJ is not required to take medical 28 43 1 opinions at face value, but may take into account the quality of the 2 explanation when determining how much weight to give a medical 3 opinion.”); Thomas, 278 F.3d at 957 (“The ALJ need not accept the 4 opinion of any physician including the treating physician, if that 5 opinion is brief, conclusory and inadequately supported by clinical 6 findings.”); see also 20 C.F.R. § 404.1527(d)(3) (“The more a medical 7 source presents relevant evidence to support a medical opinion, 8 particularly medical signs and laboratory findings, the more weight we 9 will give that medical opinion. The better an explanation a source 10 provides for a medical opinion, the more weight we will give that 11 medical opinion.”).9 12

13 In addition, ALJ Arno properly discounted Dr. Flores’s opinions 14 15 about Plaintiff’s limitations if she were to return to work, (AR 1335), 16 noting that Dr. Flores’s opinion about Plaintiff not having a job in 17 which she handles stress was vague, (id. [“what is stressful is 18 subjective and could differ on a case-by-case basis.”]), and Dr. Flores 19 did not specify what Plaintiff should be precluded from doing in the 20 workplace (other than not working at heights) or what Plaintiff was 21 capable of doing in the workplace despite her impairments. Id.. See 22 Meanel, 172 F.3d at 1114; 20 C.F.R. § 404.1527(a)(1). Moreover, ALJ 23 24 9 Although Dr. Flores stated that he considered the detailed 25 post-treatment test results/data contained in a Psychological Test Report when rendering his opinions about, inter alia, Plaintiff’s work 26 restrictions and Plaintiff’s work function abilities, and that the post- treatment Psychological Test Report would be sent as an addendum to the 27 September 5, 2006 Comprehensive Psychological Medical-Legal Permanent and Stationary Evaluation Report (see AR 428-29), the Court has been 28 unable to locate that Psychological Test Report in the record. 44 1 Arno also properly found that the RFC determination, which precluded 2 Plaintiff from work requiring a high-quota production-rate pace, and 3 limited Plaintiff to simple and routine tasks and only occasional 4 contact with the public and occasional interaction with coworkers (AR 5 1327) sufficiently addressed Dr. Flores’s workplace limitations. (AR 6 1335). 7

8 Finally, ALJ Arno’s Step Four finding that Plaintiff could not 9 perform her past relevant work was not inconsistent with Dr. Flores’s 10 opinions that Plaintiff should not return to the job she was performing 11 at the time of her Workers’ Compensation claim, a finding which 12 Plaintiff does not appear to contest. 13 14 15 Therefore, the ALJ provided clear and convincing and/or specific 16 and legitimate reasons for rejecting Dr. Flores’s opinions. 17 18 ORDER 19 20 For the foregoing reasons, the decision of the Commissioner is 21 AFFIRMED. 22 23

LET JUDGMENT BE ENTERED ACCORDINGLY.

24 25 DATED: February 16, 2021. 26

27 /s/

ALKA SAGAR

28

UNITED STATES MAGISTRATE JUDGE

45