Source: s3://data.kl3m.ai/documents/govinfo/USCOURTS/USCOURTS-azd-4_13-cv-00255/USCOURTS-azd-4_13-cv-00255-0/pdf.json

Nature of Suit Code: 863
Nature of Suit: Social Security - DIWC/DIWW (405(g))
Cause of Action: 42:405 Review of HHS Decision (SSID)

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IN THE UNITED STATES DISTRICT COURT 

FOR THE DISTRICT OF ARIZONA 

Dale William Ray Farmer, 

Plaintiff, 

v. 

Carolyn W. Colvin, Acting Commissioner 

of Social Security, 

Defendant.

No. CV-13-00255-TUC-JGZ (BPV)

REPORT AND RECOMMENDATION

Plaintiff, Dale William Ray Farmer, filed this action for review of the final 

decision of the Commissioner of Social Security pursuant to 42 U.S.C. § 405(g). Plaintiff 

presents three issues on appeal: whether the Administrative Law Judge (“ALJ”) erred by 

failing to give controlling evidentiary weight to the treating and examining providers; (2) 

whether the ALJ properly evaluated and weighed the opinion of the March 13, 2009 

consultative examiner; and (3) whether the ALJ found clear and convincing reasons for 

an adverse credibility finding. (Doc. 18.) Pending before the court is an Opening Brief 

filed by Plaintiff (Doc. 18), the Commissioner’s Opposition (Doc. 20), and Plaintiff’s 

Reply Brief (Doc. 21). Pursuant to the Rules of Practice of this Court, this matter was 

referred to Magistrate Judge Bernardo P. Velasco for a Report and Recommendation. 

(Doc. 5.) Based on the pleadings and the administrative record submitted to the Court, the 

Magistrate Judge recommends that the District Court, after its independent review, affirm 

the decision of the ALJ. 

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I. Procedural History 

Plaintiff filed an application for Supplemental Security Income (“SSI”) on October 

1, 2008, with a protective filing date of September 25, 2008, alleging an onset of 

disability beginning July 1, 2007 due to a seizure disorder. Transcript/Administrative 

Record (“Tr.”) 83, 158-67, 220. The application was denied initially and on 

reconsideration. Tr. 78-79. A hearing before an ALJ was held on October 20, 2010. Tr. 

35-54. The ALJ issued a decision on November 10, 2010 finding Plaintiff not disabled 

within the meaning of the Social Security Act. Tr. 83-88. The Appeals Council granted a 

request for review and vacated the hearing decision and remanded the case to the ALJ for 

additional evidence and further evaluation. Tr. 91-93. 

On remand, a second hearing was held before the ALJ on February 7, 2012. Tr. 

55-77. The ALJ issued a decision on March 9, 2012 finding Plaintiff not disabled. Tr. 13-

26. This decision became the Commissioner’s final decision when the Appeals Council 

denied review. Tr. 1-3. Plaintiff then commenced this action for judicial review pursuant 

to 42 U.S.C. § 405(g). (Doc. 1) 

II. The Record on Appeal 

a. Plaintiff’s Background and Statements in the Record 

Plaintiff, forty (40) years of age at the date of the ALJ’s March 2012 decision, 

completed the eleventh grade in school with past relevant work in construction and 

maintenance. Tr. 59-60, 63, 212. 

Plaintiff testified at a hearing before the ALJ on October 20, 2010 that he had 

worked most recently growing and harvesting tomatoes in a greenhouse from August 

2009 until January or February, 2010. Tr. 41-42. Plaintiff testified he was laid off in 

December, and again in February because there was no more work. Tr. 42. 

Plaintiff first started having seizures when he was eleven years old. Tr. 44. He 

testified that he felt he could no longer work because he was having seizures two to three 

times a week, including grand mal seizures with strokes. Tr. 44. Plaintiff acknowledged 

that he went through a period, a year and three months before December 2008, when he 

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did not have any seizures. Tr. 44. Plaintiff testified that the seizures were becoming more 

frequent, causing Plaintiff to lose function of the right side of his body, and taking him a 

day to a week afterwards to fully recover. Tr. 48-49. 

Plaintiff also testified that in addition to the seizures, he had one leg that was half 

an inch shorter than the other, and problems with his knee from a torn meniscus. Tr. 44-

45. Plaintiff wears lifts for the leg length discrepancy and gets shots in his knee for the 

knee problem. Tr. 44-45. Plaintiff also has migraine headaches once or twice a month, 

sometimes as frequently as two times a day, which cause nausea, vomiting, and blurred 

vision. Tr. 47-48. 

On a daily basis, Plaintiff cares for his infant daughter, feeds his dogs and picks up 

his yard. Tr. 45. He doesn’t watch television, but reads newspapers, goes grocery 

shopping, helps with laundry, and cooks all the time. Tr. 45-46. Plaintiff does not drive. 

Tr. 50. 

Plaintiff takes Depakote and Topamax, and has side effects from his medication 

consisting of drowsiness, sleepiness and numbness. Tr. 50. Plaintiff has monthly checks 

on his Depakote levels, and reports his seizures to his doctor. Tr. 51-52. 

Plaintiff testified at the second hearing, on February 7, 2012 that he was laid off in 

February 2010 from the greenhouse because of his seizures. Tr. 63. When Plaintiff asked 

his doctor what to do about it, his doctor told him no more work. Tr. 64. 

Plaintiff testified at the second hearing that his seizures were occurring more 

frequently, up to three to four times a week, and lasting for up to 25 to 45 minutes. Tr. 

65-66. After a seizure he feels “sick”, his muscles are tired, he is weak, and can’t really 

walk. Tr. 67. Additionally, he loses memory. Id. Plaintiff testified that he also has 

headaches two to three times a week. Id. 

A vocational expert (“VE”) testified that Plaintiff’s past relevant work was 

unskilled. Tr. 73. The VE testified that if Plaintiff could perform at all exertional levels, 

with the avoidance of hazards, dangerous machinery, and heights, and was further limited 

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to simple, unskilled work, he could work as a janitorial cleaner, classified as light and 

unskilled work, and as a dishwasher, classified as medium, unskilled work. Tr. 72-73. 

The VE testified that the tolerable absenteeism rate for the simple, unskilled work 

described by the VE would typically be 10 to 12 days a year. Tr. 74. Absences of two to 

three days a month would result in termination. Id. The VE further testified that there 

would be no work if an individual with the same age and education as Plaintiff had 

moderate difficulties understanding, remembering and carrying out short, simple 

instructions, and interacting appropriately with the public, co-workers, or supervisors; 

marked difficulties understanding and remembering detailed instructions, responding 

appropriately to work pressures in the usual work setting, and difficulties staying on task, 

due to malaise and who was “off task” for two hours every day and had two to three days 

of absenteeism. Tr. 74-75. 

The VE further testified that there would be no work if an individual with the 

same age and education as Plaintiff had moderate difficulties: understanding and 

remembering simple or detailed instructions; carrying out detailed instructions; with 

attention and concentration for extended periods; completing a work day without 

symptoms or the need for rest; interacting with the general public; dealing with 

instruction or criticism from a supervisor; getting along with co-workers; and maintaining 

socially appropriate behavior. Tr. 75-76. 

b. Relevant Medical Evidence Before the ALJ 

i. Treating Sources 

 Plaintiff was seen in 2004 and from 2007 to 2009 at Hidalgo Medical Services in 

Silver City, New Mexico. Tr. 275-80. In October 2004 Plaintiff reported to his treating 

physician that he had been prescribed Depakote for seizures, but had stopped taking the 

medication one and a half months prior to the appointment. Tr. 280. Plaintiff reported no 

seizures since discontinuation of Depakote (valproic acid), but did report feeling strange 

and having one fainting spell. Id. Plaintiff was prescribed Depakote and returned in 

November 2004 for a follow up visit and to check his Depakote levels. Tr. 280-81. 

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Plaintiff reported having some black-out incidents, but attributed these to his Depakote 

prescription running out. Tr. 279. After restarting on Depakote, he had no seizures or 

black-outs. Id. In December 2004, Plaintiff reported being seizure free while taking 

Depakote. Tr. 278. 

 In May 2007, Plaintiff reported to that his last seizure was 11 months previous. 

Tr. 277. Plantiff’s Depakote prescription was refilled and he was referred to James 

McCabe, M.D., to continue care and to order an EEG. Id. 

 In June 2007 Plaintiff reported to Dr. McCabe that his last seizure was in March 

2007, and that he occasionally takes extra Depakote to prevent seizures. Tr. 275. Plaintiff 

reported episodes of confusion in the week prior to the visit. Id. Dr. McCabe prescribed 

Depakote and referred plaintiff for an EEG. Tr. 276. 

 Between July 2007 and November 2008, records from Hidalgo Medical Services 

indicate that Plaintiff did not show for scheduled office visits in July 2007, and canceled 

one visit and did not show for another scheduled office visit in June 2008. Tr. 309. There 

are no records of any other visits to Hidalgo Medical Services during this time. 

 Records from Carlsbad Medical Center indicate that he was seen in October 2007 

in the emergency department for treatment of possible seizure activity. Tr. 289. Plaintiff 

reported missing four days of his prescribed seizure medication. Tr. 291. Plaintiff 

reported having only one seizure in the past year and none for the past two months. Tr. 

290-91. Plaintiff was discharged from the emergency room the same day, stable and 

walking, with instructions to restart his Depakote. Tr. 291-92. 

 In December 2008 Plaintiff reported to Alison Gomez, M.D., that he had a 

“breakthrough seizure” in September 2007. Tr. 310. He also reported not taking all of his 

medication on some days, but taking extra doses when he feels a seizure is coming on. Id. 

Dr. Gomez changed his Depakote prescription from a dose of 250 milligrams four times 

daily to a dose of Depakene ER 1000 milligrams once daily to improve compliance. Tr. 

310. Plaintiff’s Depakote levels were tested and found to be below therapeutic range. Tr. 

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314. Additionally, Dr. Gomez noted that Plaintiff had not had the EEG done. Tr. 310. 

Plaintiff did not show for a January 2009 follow up appointment. Tr. 309. 

 In March 2009 Plaintiff was seen at Gila Regional Medical Center emergency 

room, and though the record of the visit is incomplete, Plaintiff was instructed to follow 

up with his physician and take his medications as directed, and to return to the emergency 

room if his symptoms worsened. Tr. 332. 

 In April 2009 Plaintiff received emergency treatment after reportedly having a 

seizure at work. Tr. 452. 

 In May 2009, Plaintiff was seen by Jeffrey Bushman, D.O., to reestablish care. Tr. 

364. Plaintiff reported to Dr. Bushman that he had a “big seizure a week ago.” Id. 

Plaintiff reported he was currently taking Depakote 250 milligrams three times a day, and 

it was “doing okay for him.” Id. 

 In July 2009, Plaintiff again received emergency treatment for a seizure, but was 

discharged as stable that same day. Tr. 445-47. 

 In September 2009 Plaintiff reported to Dr. Bushman that he was having about 5 

migraines a month, and Ibuprofen and Excedrin were not helping. Tr. 363. Plaintiff 

reported having a seizure a month prior to the visit, and having had 3 seizures since May 

2008. Id. Dr. Bushman prescribed Maxalt and Topamax, to help with both the migraines 

and the headaches. Id. Lab results from September showed that Plaintiff’s Depakote 

levels were “very low.” Tr. 365-66. 

 In October 2009 Plaintiff reported to Dr. Bushman having his last seizure a month 

prior, and that the Topamax and Maxalt were helping with his migraines. Tr. 362. 

Plaintiff’s Depakote levels were quite low, and Plaintiff reported having decreased his 

dosage due to complaints of fatigue and “zoning out.” Tr. 382. Dr. Bushman encouraged 

Plaintiff to take his medication, informing him that he would build up a tolerance to it 

and the side effects would go away. Id. 

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 At a second appointment with Dr. Bushman in October 2009 Plaintiff reported 

fewer seizures with the increase in Depakote dosage, but that the Topamax was not 

helping his migraines much yet. Tr. 381. 

 In November 2009 Plaintiff reported having fewer seizures and migraines since 

taking his prescribed medication, but still having some. Id. Dr. Bushman deferred 

adjusting his medication further as Plaintiff had an appointment to see a neurologist. Id. 

 In January 2010 Plaintiff was seen by Robert Foote, M.D., at the Center for 

Neurosciences in Tucson, Arizona. Tr. 358. Plaintiff reported two or three seizures a 

month, with the last reported seizure in October 2009. Id. His Depakote dosage was 

increased at that time, and Topamax was added. Plaintiff reported migraines for the last 

year, with pain reported as a 9 on a scale of 1-10, lasting 5-10 minutes, but requiring 

three or four days for full recovery. Id. Dr. Foote assessed Plaintiff with migraine and 

seizure disorder, and felt he was “doing much better on his current regimen” and would 

not need to see him for three months. Tr. 360. Dr. Foote did not add any additional 

medications for the headaches since they were so brief, but noted that the Topamax 

should help with the headaches. Id. 

 In February 2010, Dr. Bushman authored a letter stating that Plaintiff “suffers 

from a severe seizure disorder and migraine headaches and GERD. His neurologist Dr. 

Robert Foote, has concurred that he should not work any more at this point, that his 

seizures are uncontrolled basically. He still has them and is unable to work, and I agree.” 

Tr. 361. Dr. Bushman also completed a Report of Illness or Physical Disability form, 

noting that Plaintiff was unable to work as of September 2007; and was advised in 

January 2010 to take time off from work for treatment and/or recovery. Tr. 436. Dr. 

Bushman found functional limitations consisting of marked limitations in the ability to 

maintain attention and concentration for extended periods and work in coordination with 

or proximity to others without being distracted, moderate limitations in the ability to 

make a simple work related decision and accept instructions and respond appropriately to 

criticism from supervisors, and slight limitations in the ability to respond appropriately to 

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changes in the work setting. Tr. 438-39. On average, Dr. Bushman noted that he 

anticipated Plaintiff’s impairments or treatment would cause him to be absent from work 

more than three times a month. Tr. 439. In Dr. Bushman’s opinion, Plaintiff was not 

capable of performing a full-time job. Id. 

 In May 2010, Plaintiff reported to Dr. Foote that he had one or two minor seizures 

since his last visit, but that he was incoherent for “a couple of days after.” Tr. 367. Dr. 

Foote increased his Depakote dosage, and ordered blood tests. Id. 

 In September 2010 Plaintiff reported to Dr. Bushman that he had 12 seizures in the 

past month, as well as chronic migraines. Tr. 373. 

 On January 17, 2011 Plaintiff was seen by Dr. Foote for a follow-up to a seizure 

that occurred on January 12, 2011. Tr. 386. The seizure caused Plaintiff to stop breathing, 

and he bit his tongue. Tr. 386, 411. Plaintiff was taken to Northern Cochise Community 

Hospital where he was kept overnight. Tr. 386, 410-411. Despite the Depakote dosage 

increase prescribed by Dr. Bushman, Plaintiff’s Depakote levels were low and he was 

given additional valproic acid intravenously and sent home. Tr. 386, 414. Plaintiff’s wife 

said he has been taking his Depakote regularly. Tr. 386. Dr. Foote noted that his seizures 

seemed to be accompanied by low Depakote levels, and increased his dosage and planned 

to take blood levels monthly. Id. Plaintiff’s blood levels taken later that same month were 

within range. Tr. 409. 

 In September 2011, Plaintiff established care with Dawn Walker, D.O. Tr. 429. 

Plaintiff reported a history of seizures. Tr. 428. In October 2011, Plaintiff was seen by 

Dr. Walker to complete disability paperwork. Plaintiff reported a history of seizure 

disorder, not controlled, with medications managed by Dr. Foote. Tr. 426. Dr. Walker 

opined that Plaintiff would be absent from work two to three days a month due to seizure 

and two to three days a month due to fatigue, and in an eight hour workday would be “off 

task” due to fatigue for two hours. Tr. 435. In December 2011 Dr. Walker opined that 

Plaintiff’s seizures occurred monthly, and that his medications were at therapeutic levels, 

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but did not completely control his seizures. Tr. 433-434. In January 2013, Dr. Walker 

opined that he would be absent 1 to 15 days per month. Tr. 454. 

ii. Examining Sources 

 King Okiri, Psy.D., performed a consultative psychological evaluation of Plaintiff 

in March 2009. Tr. 326-331. At that time, Plaintiff reported to Dr. Okiri being unable to 

pay for his medications, and suffering from four to five seizures a day without 

medication. Tr. 326. Plaintiff reported last being in the hospital over ten years previous 

and denied being admitted to a hospital for seizures, and stated he was healthy with no 

record of ever going to the hospital. Tr. 328. Dr. Okiri noted that although Plaintiff was 

cooperative during the interview he appeared to be “trying to make himself look good,” 

possibly due to the presence of his girlfriend during the interview. Id. 

 Dr. Okiri administered the Wechsler Adult Intelligence Scale - IV to Plaintiff to 

assess his reasoning and thinking ability and reported that Plaintiff put forth good effort 

and put forth the required effort but Plaintiff’s overall psychological performance was 

poor. Tr. 328. Dr. Okiri assessed Plaintiff with “Cognitive Disorder NOS” and 

“Borderline Intellectual Functioning.” Tr. 327. Dr. Okiri opined: 

[Plaintiff’s] ability to understand and remember basic instructions would be 

moderately limited given the results of psychological verbal comprehension 

index score of 80. [Plaintiff’s] ability to concentrate and persist at tasks at 

the workplace would be moderately limited given results of psychological 

testing. His interaction with the general public and coworkers would be 

mildly limited given the claimant’s own statements. [Plaintiff’s] ability to 

adapt to changes in the workplace would be moderately limited given his 

seizure disorder. If the severity of his seizures can be substantiated, then his 

ability to adapt to changes in the work environment would be markedly 

limited.” 

Tr. 329. 

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iii. Non-Examining State Agency Medical Sources 

 Elieen Brady, M.D., completed a Physical Residual Functional Capacity 

Assessment form on January 31, 2009. Tr. 318-25. Dr. Brady concluded that Plaintiff 

could perform all work with limitations noted only for moderate exposure to hazards. Id.

 Elizabeth Chiang, M.D., completed a Psychiatric Review Technique form based 

on Plaintiff’s diagnoses of Cognitive Disorder and Borderline Intellectual Functioning. 

Tr. 336-48. In Paragraph “B” Criteria of the Listings, Dr. Chiang rated Plaintiff’s 

functional limitations, finding mild restriction of activities of daily living, moderate 

limitations in maintaining social functioning and in maintaining concentration, 

persistence or pace, and insufficient evidence to determine episodes of decompensation. 

Tr. 346. 

 Dr. Chiang also completed a Mental Residual Functional Capacity Assessment 

form on March 16, 2009. Tr. 333-35. Dr. Chiang concluded that Plaintiff would be 

moderately limited in the ability to: understand and remember very short and simple 

instructions; understand and remember or carry out detailed instructions; maintain 

attention and concentration for extended periods; complete a normal workday and 

workweek without interruptions from psychologically based symptoms and to perform at 

a consistent pace without an unreasonable number and length of rest periods; interact 

appropriately with the general public; accept instructions and respond appropriately to 

criticism from supervisors; get along with coworkers or peers without distracting them or 

exhibiting behavioral extremes; and maintain socially appropriate behavior and to adhere 

to basic standards of neatness and cleanliness. Tr. 333-34. Dr. Chiang completed a 

functional capacity assessment, concluding that “Claimant can understand, remember and 

carry out simple instructions, make simple decision, attend and concentrate for two hours 

at a time, interact adequately with co-workers and supervisors and respond appropriately 

to change in a routine work setting.” Tr. 335. 

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iv. Other records and witnesses 

 Plaintiff completed a seizure diary, recording four seizures that occurred in 2010, 

all small or very small, and seven seizures that occurred during 2011, reporting one to 

have been very large requiring hospitalization. Tr. 431-32. The diary noted his seizures 

were witnessed by his wife. Tr. 431-32. 

c. The ALJ’s Findings 

 The ALJ found that Plaintiff had not engaged in substantial gainful activity since 

the date of application, September 25, 2008. Tr. 17, 18 ¶ 2. The ALJ found that Plaintiff 

has the severe impairment of seizure disorder. Tr. 18, ¶ 2. The ALJ found that Plaintiff’s 

impairments, including his mental impairment, do not meet or equal a listed impairment. 

Id., ¶ 3. The ALJ further found that in considering Plaintiff’s mental impairment, the 

“paragraph B” criteria were not satisfied because Plaintiff has no restrictions in his 

activities of daily living; mild difficulties in social functioning, moderate difficulties with 

regard to concentration, persistence or pace; and no episodes of decompensation which 

have been of extended duration. Tr. 19. The ALJ found that Plaintiff failed to establish 

that the “paragraph C” criteria are satisfied. Id. The ALJ stated that the RFC 

determination reflected the degree of limitation the ALJ found in the “paragraph B” 

mental function analysis. Tr. 19-20. The ALJ found that Plaintiff had the RFC to perform 

a full range of work at all exertional levels, but with the following nonexertional 

limitations: Plaintiff should avoid exposure to work hazards such as moving machinery 

and unprotected heights; and is limited to simple, unskilled work. Tr. 20, ¶ 4. The ALJ 

found that Plaintiff had no past relevant work. Tr. 24, ¶ 5. At step five, the ALJ 

considered Plaintiff’s RFC in conjunction with the Medical-Vocational Guidelines, his 

age, limited education and work experience, and testimony by a vocational expert that 

there are jobs that exist in significant numbers in the national economy that Plaintiff can 

perform, and concluded that Plaintiff is not disabled. Tr. 24-25, ¶¶ 6-10. 

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III. Discussion 

a. Standard of Review 

 The Court has the “power to enter, upon the pleadings and transcript of the record, 

a judgment affirming, modifying, or reversing the decision of the Commissioner of Social 

Security, with or without remanding the cause for a rehearing.” 42 U.S.C. § 405(g). The 

Commissioner’s decision to deny benefits “should be upheld unless it is based on legal 

error or is not supported by substantial evidence.” Ryan v. Comm’r of Soc. Sec., 528 F.3d 

1194, 1198 (9th Cir. 2008). In determining whether the decision is supported by 

substantial evidence, the Court “must consider the entire record as a whole and may not 

affirm simply by isolating a ‘specific quantum of supporting evidence.’” Id. (quoting 

Robbins v. Commissioner, Soc. Sec. Admin., 466 F.3d 880, 882 (9th Cir. 2006)). 

 Whether a claimant is disabled is determined using a five-step evaluation process. 

To establish disability, the claimant must show (1) he has not worked since the alleged 

disability onset date, (2) he has a severe impairment, and (3) his impairment meets or 

equals a listed impairment or (4) his residual functional capacity (RFC) precludes him 

from performing his past work. At step five, the Commissioner must show that the 

claimant is able to perform other work. See 20 C.F.R. §§ 416.920(a)-(g). 

b. Analysis 

i. Treating Sources 

 Plaintiff argues that the ALJ erred in not giving controlling weight to the opinions 

of Dr. Bushman, Dr. Foote, and Dr. Walker. The Commissioner responds that the ALJ 

cited specific reasons supported by the evidence for discounting Dr. Bushman’s opinion, 

as well as Dr. Foote’s opinion. The Commissioner also asserts that the ALJ provided 

specific and legitimate reasons for finding that Dr. Walker’s opinions were not entitled to 

controlling weight. 

 Generally, more weight is given to the opinion of a treating source than the 

opinion of a doctor who did not treat the claimant. See Turner v. Comm’r of Soc. Sec. 

Admin., 613 F.3d 1217, 1222 (9th Cir. 2010); Winans v. Bowen, 853 F.2d 643, 647 (9th

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Cir. 1987). Medical opinions and conclusions of treating physicians are accorded special 

weight because these physicians are in a unique position to know claimants as 

individuals, and because the continuity of their dealings with claimants enhances their 

ability to assess the claimants’ problems. See Embrey v. Bowen, 849 F.2d 418, 421-22 

(9th Cir. 1988); Winans, 853 F.2d at 647; see also Bray v. Comm’r of Soc. Sec. Admin., 

554 F.3d 1219, 1228 (9th Cir. 2009) (“A treating physician’s opinion is entitled to 

‘substantial weight.’”). If a treating doctor’s opinion is not contradicted by another doctor 

(i.e., there are no other opinions from examining or nonexamining sources), it may be 

rejected only for “clear and convincing” reasons supported by substantial evidence in the 

record. See Ryan, 528 F.3d at 1198; Lester v. Chater, 81 F.3d 821, 830 (9th Cir. 1996). 

 The ALJ accords “controlling weight” to a treating doctor’s opinion where 

medically-approved, diagnostic techniques support the opinion and the opinion is not 

inconsistent with other substantial evidence. See 20 C.F.R. § 416.927(c)(2); Lingenfelter 

v. Astrue, 504 F.3d 1028, 1038 n.10 (9th Cir. 2007); Orn v. Astrue, 495 F.3d 625, 632-33 

(9th Cir. 2007). If the opinion is not accorded controlling weight, then the ALJ looks to a 

number of other factors in determining how much weight to give it. These factors include 

the length of the treatment relationship, frequency of examination, nature and extent of 

treatment relationship, evidence supporting the treating doctor’s opinion, consistency of 

the opinion, and the doctor’s specialization. See 20 C.F.R. § 416.927(c)(2)-(c)(6). 

 In February 2010 Dr. Bushman authored a letter stating that he agreed with Dr. 

Foote that Plaintiff should not work because his seizures were “uncontrolled basically.” 

Tr. 361.1

 In May 2010 Dr. Bushman also reported that Plaintiff was unable to work as of 

 

1

 Dr. Foote’s opinion is presented only indirectly through the treatment notes and opinions of Dr. Bushman. See Tr. 379 (Dr. Bushman’s treatment notes indicate Dr. Foote 

recommends that Plaintiff not work); Tr. 361 (Dr. Bushman’s opinion indicates that Dr. Foote concurs that Plaintiff should not work, and that his seizures are uncontrolled). 

There is no independent opinion evidence from Dr. Foote in the record indicating he believed Plaintiff could not work. Because there is no separate opinion in the record from Dr. Foote, and because Plaintiff only argues that Dr. Foote’s opinion in concurrence with 

Dr. Bushman was improperly rejected, the Court does not address this opinion as the separate opinion on the ultimate issue of disability by Dr. Foote. 

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September 2007, and noted functional limitations consisting of marked and moderate 

mental limitations. Tr. 437-40. 

 The ALJ acknowledged Dr. Bushman as Plaintiff’s treating physician. Tr. 21. 

Treating physicians’ uncontroverted “ultimate conclusions . . . must be given substantial 

weight; they cannot be disregarded unless clear and convincing reasons for doing so exist 

and are set forth in proper detail.” Embrey, 849 F.2d at 422. Although the ALJ “‘is not 

bound by the uncontroverted opinions of the claimant’s physicians on the ultimate issue 

of disability, . . . he cannot reject them without presenting clear and convincing reasons 

for doing so.’” Matthews v. Shalala, 10 F.3d 678, 680 (9th Cir. 1993) (quoting Montijo v. 

Sec’y of Health & Human Servs., 729 F.2d 599, 601 (9th Cir. 1984) (per curiam)); see 

also Reddick v. Chater, 157 F.3d 715, 725 (9th Cir. 1998) (stating that “reasons for 

rejecting a treating doctor’s credible opinion on disability are comparable to those 

required for rejecting a treating doctor’s medical opinion”); Lester, 81 F.3d at 830. When 

rejecting the opinion of a treating physician, the ALJ can meet this "'burden by setting out 

a detailed and thorough summary of the facts and conflicting clinical evidence, stating his 

interpretation thereof, and making findings.'" Tommasetti v. Astrue, 533 F.3d 1035, 1041 

(9th Cir. 2008)(quoting Magallanes v. Bowen, 881 F.2d 747, 751 (9th Cir. 1989)). The 

Social Security Administration has explained that an ALJ's finding that a treating source 

medical opinion is not well-supported by medically acceptable evidence or is inconsistent 

with substantial evidence in the record means only that the opinion is not entitled to 

controlling weight, not that the opinion should be rejected. Orn, 495 F.3d at 632 (citing 

20 C.F.R. § 404.1527). Treating source medical opinions are still entitled to deference 

and, “[i]n many cases, will be entitled to the greatest weight and should be adopted, even 

if it does not meet the test for controlling weight." Orn, 495 F.3d at 632; see also

Murray,722 F.2d at 502 ("If the ALJ wishes to disregard the opinion of the treating 

physician, he or she must make findings setting forth specific, legitimate reasons for 

doing so that are based on substantial evidence in the record."). 

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 The ALJ gave minimal weight to Dr. Bushman’s opinions regarding Plaintiff’s 

ability to work because the opinions were “in direct contrast to his own opinions and 

treatment record, as well as other evidence of record.” Tr. 22. The ALJ noted specifically 

that Dr. Bushman had authored contradictory opinion letters regarding Plaintiff’s ability 

to work, and had “relied quite heavily on the subjective report of symptoms and 

limitations” provided by the Plaintiff, uncritically accepting Plaintiff’s reports as true, 

when there “exists good reasons for questioning the reliability of the [Plaintiff’s] 

subjective complaints. Tr. 22. 

 Plaintiff argues that the ALJ did not cite to any specific “other evidence of record” 

in support of his conclusion. Contrary to this assertion, the ALJ specifically noted that 

there was no recent mention of headache or seizures in the treatment records from 2010. 

Tr. 22. The ALJ’s conclusion finds support in the record. 

 Dr. Bushman’s treatment notes indicated that from May 2008 to September 2009, 

when Dr. Bushman began treating Plaintiff, Plaintiff reported having 3 seizures. In 

October and November 2009, Plaintiff reported having fewer seizures. Tr. 381. In 

December 2009 and February 2010, although he had several visits with Dr. Bushman, 

Plaintiff did not report any seizures. Tr. 378-80. In March 2010, Plaintiff told Dr. 

Bushman only that “his seizures [were] occurring every once in a while.” Tr. 378. In May 

2010, Plaintiff saw Dr. Foote, reporting only one or two “minor seizures” since his last 

visit five months prior. Tr. 367. Although Plaintiff saw Dr. Bushman in May 2010, Dr. 

Bushman did not note any recent seizures and only stated that Plaintiff “had a lot of 

paperwork . . . regarding disability which we filled out together.” Tr. 376. This treatment 

note is in direct contrast to Plaintiff’s assertion that Dr. Bushman noted seizure activity 

on each clinical visit. See Doc. 18, at 7; Tr. 379 (treatment notes from February 18, 2010, 

indicating problems with insomnia, but no reported seizure activity). Finally, although 

Plaintiff reported in September 2010 having 12 seizures the previous month, (Tr. 373), 

this appointment was after Dr. Bushman authored both of his opinions, and was contrary 

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to Plaintiff’s report in his seizure diary of only having four seizures throughout 2010. Tr. 

430-31. 

 The ALJ reasonably concluded that Dr. Bushman’s extreme May 2010 opinion 

indicating that Plaintiff’s “uncontrolled” seizure disorder would completely preclude any 

work activity was unsupported by Dr. Bushman’s treatment record, Dr. Bushman’s 

opinion stating that Plaintiff could work, and other evidence of record (Tr. 22). See 20 

C.F.R. § 416.927(c)(4) (greater weight given to opinions that are consistent with the 

record as a whole); Bayliss v. Barnhart, 427 F.3d 1211, 1216 (9th Cir. 2005) (discrepancy 

between treating doctor’s opinion and his notes and other opinions regarding claimant’s 

capabilities provided a clear and convincing reason for not relying on the doctor’s 

opinion). 

 Plaintiff argues that the ALJ offered only conclusions without citation to specific, 

legitimate reasons supported by substantial evidence in support of his conclusions. See

Doc. 18, at 7. Contrary to this allegation, the ALJ specifically noted specific instances in 

the record where, at Plaintiff’s request, Dr. Bushman authored opinions indicating that 

Plaintiff both could and could not work. See Tr. 22 (comparing Exhibit B17F/3 with 

Exhibit B24F). Additionally, the ALJ noted that Dr. Bushman “relied quite heavily on the 

subjective report of symptoms and limitations provided by [Plaintiff] and seemed to 

uncritically accept as true, most, if not all” of what Plaintiff reported despite the existence 

of “good reasons for questioning the reliability of [Plaintiff’s] subjective complaints.” Tr. 

22. Indeed, Dr. Bushman’s physical examinations of Plaintiff were mostly normal, there 

were few clinical findings, and Dr. Bushman appeared to rely mainly on Plaintiff’s 

subjective reports (e.g., Tr. 363, 378, 380-82). Therefore, the ALJ appropriately found 

that Dr. Bushman’s assessment was based on Plaintiff’s subjective complaints (which the 

ALJ found not fully credible), because his treatment notes did not generally support the 

extreme limitations he assessed. See 20 C.F.R. § 416.927(c)(3) (“The more a medical 

source presents relevant evidence to support an opinion, particularly medical signs and 

laboratory findings, the more weight we will give that opinion.”); id. § 416.927(c)(4) 

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(ALJ must consider consistency of opinion with record). The Ninth Circuit has held that 

“[a] physician's opinion of disability premised to a large extent upon the claimant's own 

accounts of his symptoms and limitations may be disregarded where those complaints 

have been properly discounted.” Morgan v. Commisioner of Social Sec. Admin., 169 F.3d 

595, 602 (9th Cir. 1999) (internal quotations and citations omitted); see also Fleming v. 

Commissioner of Social Sec. Admin., 500 Fed.Appx. 577 (9th Cir. 2012) (ALJ reasonably 

discounted opinion of examining physician which was internally inconsistent and based 

on claimant’s subjective complaints which the ALJ had separately rejected as unreliable, 

and there was little clinical support for those findings). As discussed below, there was no 

error in the ALJ’s findings that Plaintiff’s subjective complaints were not entirely 

credible. 

 Plaintiff also asserts that the ALJ failed to give controlling evidentiary weight to 

Plaintiff’s treating neurologist, Dr. Foote. (See Doc. 18, at p. 8.) Plaintiff refers to no 

independent opinion evidence in the record from Dr. Foote. Presumably, Plaintiff’s 

argument rests on Dr. Bushman’s assertion that Dr. Foote concurred with Dr. Bushman’s 

opinion that Plaintiff should not work. Tr. 361. It is not clear from the record that Dr. 

Bushman’s statement that Dr. Foote concurred with his assessment was based on 

communications between Dr. Bushman and Dr. Foote, or based on Plaintiff’s report to 

Dr. Bushman of Dr. Foote’s assessment. The source of the assertion was not established, 

and there is no opinion in the record from Dr. Foote on the issue of disability. Regardless, 

for the reasons stated above, the ALJ did not err in rejecting the opinion evidence 

submitted by Dr. Bushman even if it is also considered to be the opinion of Dr. Foote. At 

the time Dr. Bushman wrote the letter stating Dr. Foote concurred with his opinion that 

Plaintiff could not work, Dr. Foote had treated Plaintiff only one time, noting in January 

2010 that Plaintiff had not had a seizure since October 2009. This is substantial evidence 

supporting the ALJ’s decision. Additionally, to the extent the ALJ addressed Dr. Foote’s 

medical opinion, the ALJ’s interpretation of Dr. Foote’s treatment notes is supported by 

the record, and supports the ALJ’s ultimate conclusion. The ALJ noted that Dr. Foote 

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first treated Plaintiff for migraines and seizures in January 2010. Tr. 21-22. At that time, 

Plaintiff reported having had his last seizure in October 2009. Tr. When Plaintiff returned 

to Dr. Foote in May, 2010, Plaintiff reported having only one or two minor seizures since 

his visit in January. Plaintiff next saw Dr. Foote after having a major seizure that 

occurred on January 12, 2011.Tr. 386-87. These treatment notes suggest that Plaintiff 

reported only four seizures to Dr. Foote over the course of more than a year. This 

supports the ALJ’s conclusion that although Plaintiff had a medically determinable 

impairment, the alleged severity of the seizures was not substantiated by the evidence of 

record. 

 Finally, the Plaintiff argues that the ALJ erred by not giving controlling weight to 

the opinion of Dr. Walker, Plaintiff’s treating physician from September 2011 through 

January 2013. Tr. 424-35. In December 2011, Dr. Walker opined that Plaintiff would be 

absent from work two to three days a month due to seizure and two to three days a month 

due to fatigue, and in an eight hour workday would be “off task” due to fatigue for 2 

hours. Tr. 435. Dr. Walker stated that Plaintiff’s seizures occurred monthly, and that his 

medications were at therapeutic levels, but did not completely control his seizures. Tr. 

433-434. In January 2013, Dr. Walker opined that he would be absent 1 – 15 days per 

month. Tr. 454. 

 The ALJ gave minimal weight to Dr. Walker’s opinion because Dr. Walker’s 

treatment notes indicated that she was not treating Plaintiff for his seizure disorder, but 

that Dr. Foote was Plaintiff’s treating physician managing his care for seizure disorder. 

Tr. 22. Additionally, the ALJ noted that Dr. Walker’s assessment was inconsistent with 

her own treating records as she did not have a treating relationship regarding Plaintiff’s 

seizures. Tr. 22. 

 The ALJ provided specific and legitimate reasons supported by substantial 

evidence in the record for finding that Dr. Walker’s opinion was not entitled to 

controlling weight. The medical evidence of record indicates that prior to Dr. Walker’s 

December 2011 opinion, Plaintiff was seen by Dr. Walker once to establish care and treat 

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a rash, at which time he reported a history of seizure disorder, but did not report any 

recent seizures to Dr. Walker (Tr. 428-29), a second time to have Dr. Walker fill out 

disability paperwork to establish disability due to seizure disorder (Tr. 426-27), and 

finally, a third time to treat a laceration on his arm (Tr. 424-25). 

 Thus, the ALJ properly concluded that Dr. Walker’s very limited treatment notes 

did not support Dr. Walker’s opinion on the issue of disability. 

ii. Examining Source 

 Plaintiff asserts that the ALJ failed to comply with the Appeals Council remand 

order directing the ALJ to evaluate and weigh the opinion of consultative examiner Dr. 

Okiri. (Doc. 18, at 8.) The Commissioner correctly asserts that the ALJ reasonably 

complied with the Appeals Council’s order. 

 After the first hearing, the ALJ issued a decision denying benefits. Tr. 83-88. The 

Appeals Council vacated the ALJ’s decision and remanded the case to the ALJ with 

directions to address and evaluate Dr. Okiri’s March 2009 opinion, and further evaluate 

Plaintiff’s mental impairments in light of that opinion. Tr. 91. The Appeals Council noted 

that although the ALJ addressed this opinion, “no rationale or evidentiary basis was given 

for rejecting this medical source opinion” as required by regulations. Tr. 91. Additionally, 

the Appeals Council “further observed that the State Agency concurred with Dr. Okiri’s 

opinion finding that the claimant had mental impairments that would limit the claimant to 

performing only simple tasks.” Tr. 91. The Appeals Council noted that this medical 

opinion was also not evaluated in accordance with Social Security Ruling 96-6p. Tr. 91. 

 Despite Plaintiff’s argument that the ALJ disregarded the Appeals Council’s 

directions, it is evident that the ALJ considered the opinions because in the ALJ’s second 

decision the ALJ included limitations in the RFC of “simple and unskilled work,” 

reflecting the medical opinions of Dr. Okiri and Dr. Chiang.2

 The ALJ’s failure to explain 

 

2

 By denying review of the ALJ’s second decision, the Appeals Council also implicitly rejected Plaintiff’s argument that the ALJ erred in the second decision by failing to discuss the weight given to the opinions of Dr. Okiri and Dr. Chiang. See Tr. 1-

2, 10. 

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the weight given to Dr. Okiri’s opinion was inconsequential to the ultimate determination 

of nondisability and is therefore harmless. 

 The harmless error rule, as codified, requires us to “give judgment after an 

examination of the record without regard to errors or defects which do not affect the 

substantial rights of the parties.” Ludwig v. Astrue, 681 F.3d 1047, 1053 n.2 (9th Cir. 

2012)(citing 28 U.S.C. § 2111; Molina v. Astrue, 674 F.3d 1104, 1118 (9th Cir.2012); 

McLeod v. Astrue, 640 F.3d 881, 887 (9th Cir. 2011)(acknowledging that the harmless 

error rule that courts ordinarily apply in civil cases applies to Social Security cases as 

well). An ALJ’s error is harmless only where it is “inconsequential to the ultimate 

nondisability determination.” Molina, 674 F.3d at 1115 (quoting Carmickle v. 

Commissioner, Social Sec. Admin., 533 F.3d at 1155, 1162 (9th Cir. 2008); Tommasetti, 

533 F.3d at 1038; Robbins, 466 F.3d at 885; Stout v. Comm’r, Soc. Sec. Admin., 454 F.3d 

1050, 1055 (9th Cir. 2006)). 

 To the extent the ALJ omitted an explanation of the weight given to the opinions 

of the consultative examiner and State Agency reviewing physician, this omission was 

not per se prejudicial. Cf. Molina, 674 F.3d at 1121-22 (rejecting a per se rule of 

prejudice when the ALJ fails to discuss evidence); see also Shinseki v. Sanders, 556 U.S. 

396, 409 (2009) (rejecting a legal framework that would “prevent the reviewing court 

from directly asking the harmless-error question,” and that would justify “reversing for 

error regardless of its effect on the judgment” (citation and internal quotes omitted)). 

 As the ALJ explained in his decision, the limitations identified by the ALJ in the 

paragraph B criteria are not an RFC assessment, but are used to rate the severity of 

mental impairments at steps two and three of the sequential evaluation process. The RFC, 

which is assessed before going from step three to step four, requires a more detailed 

assessment by itemizing various functions contained in the broad categories found in 

paragraphs B and C of the Listing of Impairments. See 20 C.F.R. §416.920a; SSR 96-8p, 

1996 WL 374184, at *4. As correctly noted by the Commissioner, Dr. Chiang reviewed 

Dr. Okiri’s sevierty ratings and concluded that Plaintiff was capable of understanding, 

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remembering, and carrying out simple instructions, making simple decisions, attending 

and concentrating for two hours at a time, interacting adequately with co-workers and 

supervisors, and responding appropriately to changes in a routine work setting. Thus, in 

light of Dr. Okiri’s and Dr. Chiang’s opinions, the ALJ reasonably limited Plaintiff to 

simple, unskilled work. 

iii. Plaintiff’s Credibility 

 Lastly, Plaintiff argues that the ALJ’s reasoning for finding Plaintiff’s credibility 

diminished was improperly vague, and that the ALJ did not articulate any “specific 

findings” for discounting the complaints of disabling pain and limitations. (Doc. 18, at 

10.) 

 “[Q]uestions of credibility and resolution of conflicts in the testimony are 

functions solely of the Secretary.” Sample v. Schweiker, 694 F.2d 639, 642 (9th Cir. 1982) 

(internal quotation marks and citation omitted); see also Allen v. Heckler, 749 F.2d 577, 

580 n.1 (9th Cir. 1985). “The ALJ is responsible for determining credibility and resolving 

conflicts in medical testimony.” Magallanes, 881 F.2d at 750; see also Lingenfelter, 504 

F.3d at 1035-36. The ALJ’s credibility findings must be supported by specific, cogent 

reasons. See Greger v. Barnhart, 464 F.3d 968, 972 (9th Cir. 2006); Rashad v. Sullivan, 

903 F.2d 1229, 1231 (9th Cir. 1990). 

 Where, as here, the claimant has produced objective medical evidence of an 

underlying impairment that could reasonably give rise to the symptoms and there is no 

affirmative finding of malingering by the ALJ, the ALJ’s reasons for rejecting the 

claimant’s symptom testimony must be specific, clear and convincing. Tomasetti v. 

Astrue, 533 F.3d 1035 (9th Cir. 2008); Orn, 495 F.3d at 635; Robbins, 466 F.3d at 883. 

Additionally, “[t]he ALJ must state specifically which symptom testimony is not credible 

and what facts in the record lead to that conclusion.” Smolen v. Chater, 80 F.3d 1273, 

1284 (9th Cir. 1996); see also Orn, 495 F.3d at 635 (the ALJ must provide specific and 

cogent reasons for the disbelief and cite the reasons why the testimony is unpersuasive). 

When assessing a claimant’s credibility, however, the “ALJ is not required to believe 

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every allegation of disabling pain or other non-exertional impairment.” Orn, 495 F.3d at 

635 (internal quotation marks and citation omitted). Additionally, the ALJ may disregard 

self-serving statements if they are unsupported by objective evidence. Rashad, 903 F.2d 

at 1231. 

 In assessing the claimant’s credibility, the ALJ may consider ordinary techniques 

of credibility evaluation, such as the claimant’s reputation for lying, prior inconsistent 

statements about the symptoms, and other testimony from the claimant that appears less 

than candid; unexplained or inadequately explained failure to seek or follow a prescribed 

course of treatment; the claimant’s daily activities; the claimant’s work record; 

observations of treating and examining physicians and other third parties; precipitating 

and aggravating factors; and functional restrictions caused by the symptoms. 

Lingenfelter, 504 F.3d at 1040; Smolen, 80 F.3d at 1284; see also Robbins, 466 F.3d at 

884 (“To find the claimant not credible, the ALJ must rely either on reasons unrelated to 

the subjective testimony (e.g., reputation for dishonesty), on conflicts between his 

testimony and his own conduct; or on internal contradictions in that testimony.”) 

 Contrary to the Commissioner's contention, Bunnell v. Sullivan, 947 F.2d 341 (9th 

Cir. 1991), does not permit finding subjective symptom testimony not credible without 

articulating clear and convincing reasons. The Commissioner correctly quotes Bunnell as 

stating an ALJ must make specific findings, supported by the record, to support his 

conclusion that a claimant's allegations of severity are not credible. See id. at 345. But 

Bunnell does not address whether the reasons must be clear and convincing. Rather, it 

addresses whether an ALJ may discredit a claimant's allegations of the severity of pain 

solely on the ground that the allegations are unsupported by objective medical evidence. 

 An ALJ's error may be harmless where the ALJ has provided one or more invalid 

reasons for disbelieving a claimant's testimony, but also provided valid reasons that were 

supported by the record. See Bray v. Comm’r of Soc. Sec. Admin., 554 F.3d 1219, 1227 

(9th Cir. 2009); Carmickle, 533 F.3d at 1162–63; Batson v. Comm'r of Soc. Sec. Admin., 

359 F.3d 1190, 1195–97 (9th Cir. 2004). In this context, an error is harmless so long as 

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there remains substantial evidence supporting the ALJ's decision and the error “does not 

negate the validity of the ALJ's ultimate conclusion.” Batson, 359 F.3d at 1197; see also 

Carmickle, 533 F.3d at 1162. 

 The ALJ found Plaintiff’s “medically determinable impairments could reasonably 

be expected to produce the alleged symptoms; however, the claimant’s statements 

concerning the intensity, persistence and limiting effects of these symptoms are not 

credible to the extent they are inconsistent with the above residual functional capacity.” 

Tr. 20. As the Seventh Circuit Court of Appeals explains, the manner in which this 

“boilerplate language” is used in the Commissioner’s credibility analysis “gets things 

backwards.” Bjornson v. Astrue, 671 F.3d 640, 645 (7th Cir. 2012) (Addressing identical 

language and finding that the “problem is that the assessment of a claimant's ability to 

work will often ... depend heavily on the credibility of her statements concerning the 

‘intensity, persistence and limiting effects’ of her symptoms, but the passage implies that 

ability to work is determined first and is then used to determine the claimant's 

credibility.”) 

 As the Court found in Bjornson, the statement by the ALJ that Plaintiff’s 

statements were “not entirely credible” yields no clue to what weight the ALJ gave that 

testimony, and “fails to inform us in a meaningful, reviewable way of the specific 

evidence the ALJ considered in determining that claimant’s complaints were not 

credible.” Id. (citations omitted). 

 If, however, “the ALJ has made specific findings justifying a decision to 

disbelieve an allegation ... and those findings are supported by substantial evidence in 

the record, our role is not to second-guess that decision.” Morgan, 169 F.3d at 600. 

Several courts in this Circuit have found that the mere use of the meaningless boilerplate 

language is not cause for remand if the ALJ’s conclusion is followed by sufficient 

reasoning. See e.g. Jones v. Comm. of Soc. Sec., 2012 WL 6184941, at * 4 (D.Or. 

2012)(boilerplate language is a conclusion which may be affirmed if the ALJ’s stated 

reasons for rejecting the plaintiff’s testimony are clear and convincing); Bowers v. Astrue, 

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2012 WL 2401642, at *9 (D.Or. 2012)(concluding that this language erroneously 

reverses the analysis, but finding such error harmless because the ALJ cited other clear 

and convincing reasons for rejecting the claimant’s testimony). The Court adopts this 

reasoning, and, despite the use of the boilerplate language which implies improper 

analysis, considers whether the ALJ’s conclusion in this case is nonetheless supported by 

clear and convincing evidence. 

 The ALJ identified the testimony of the Plaintiff’s that he was considering, stating 

that the Plaintiff complained of “severe seizure symptoms.” Tr. 23. Although Plaintiff 

claimed that he experienced severe seizure symptoms, including three to four seizures per 

week with two to three days of recovery time after each seizure (Tr. 65-67), the ALJ 

reasonably found that the evidence as a whole suggested that Plaintiff’s impairments 

were not as severe as he alleged (Tr. 20-24). 

 First, the ALJ found that Plaintiff’s treating physicians consistently characterized 

the impairments as “minimal”, mild”, “slight”, “normal”, and “unremarkable” with 

reference to the clinical and laboratory findings. Tr. 23. This finding is consistent with 

the records from Plaintiff’s treating physicians which indicated relatively few significant 

seizures. 

 Second, the ALJ noted a number of inconsistencies which cast doubt regarding the 

credibility of Plaintiff’s testimony. Tr. 23. Significantly, Plaintiff’s testimony that he was 

having three to four seizures a week was at odds with the seizure diary he kept, and with 

the number of seizures he reported to his treating physicians. The only report in the 

medical record of seizures occurring that frequently was from Dr. Okiri’s evaluation in 

2009, where Plaintiff reported, again inconsistently with his reports to his treating 

physicians, four to five seizures a day. Tr. 326. 

 The ALJ noted that there were large gaps of time between visits to the doctor 

seeking relief. This is substantiated by the treatment notes. In 2010, when Plaintiff 

reported his seizures were becoming more frequent, he saw his neurologist only twice. 

Tr. 361, 367. 

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 The ALJ noted that Plaintiff maintained a somewhat normal level of activity and 

interaction, observing Plaintiff was independent in self-care, able to cook, clean, do 

laundry and yard work, wash dishes, grocery shop, take walks, visits friends and 

relatives, play cards, and read the newspaper (Tr. 23; see Tr. 45-46, 203-05). This is 

supported by Plaintiff’s disability report which stated that Plaintiff is able to cook, clean 

house, pick up trash, go on car trips, and shop (Tr. 242-43) as well as his testimony from 

the hearing in October 2010 that, despite having seizures two to three times a week (Tr. 

44) he spends the day watching his infant daughter. Tr. 45. The ALJ’s credibility finding 

was further bolstered by evidence that Plaintiff was staying home to care for his young 

daughter (Tr. 22; see Tr. 45, 386). Thus, the ALJ reasonably found that the activities 

reported by Plaintiff undermined his allegations of severe seizures that left him 

completely incapacitated for days (Tr. 23). See 20 C.F.R. § 416.929(c)(3)(i) (ALJ must 

consider evidence of activities); Berry v. Astrue, 622 F.3d 1228, 1234 (9th Cir. 2010) 

(ALJ properly discredited claimant by identifying contradictions between his complaints 

in an activity questionnaire, his hearing testimony, and some of his other self-reported 

activities). Contrary to Plaintiff’s assertion, this was entirely appropriate. See Morgan, 

169 F.3d at 600 (ability “to spend a substantial part of his day engaged in pursuits 

involving the performance of physical functions that are transferable to a work setting” 

can be used to discredit a plaintiff). 

 Finally, the ALJ noted that there were numerous references in the medical 

evidence indicative of Plaintiff’s non-compliance with the medical treatment specified by 

the physicians. Tr. 23. This statement is supported by the record. In October 2007, 

Plaintiff received emergency treatment for a seizure, but reported that he had missed 

recent doses of his medication Tr. 291-92. In December 2008, Plaintiff was not taking 

Depakote as prescribed, and his physician prescribed a once-daily Depakote dose to 

improve compliance. Tr. 310. Further, Plaintiff’s lab results often showed that Plaintiff’s 

Depakote levels were very low. Tr. 311, 365, 382. When Plaintiff received emergency 

treatment for a seizure in January 2011, it was noted that he had a “sub therapeutic 

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Depakote level” and Dr. Foote later opined that Plaintiff’s “seizures seem to be 

accompanied by low Depakote levels” (Tr. 22; see Tr. 386, 411). Thus, the ALJ 

reasonably determined that Plaintiff’s failure to comply with his prescribed course of 

treatment suggested that his limitations were not actually as disabling as he alleged. 

 Plaintiff submits that the ALJ erred by noting that Plaintiff’s “history of 

incarceration does not tend to increase his credibility.” (Doc. 18 at 11, see Tr. 24.) 

Consideration of evidence of prior incarceration, particularly for a crime of moral 

turpitude, is not error, and may constitute clear and convincing reasons for discounting a 

social security claimant’s testimony. See Stewart v. Colvin, 2014 WL 1355972, at *5 

(D.Ariz. 2014)(“evidence of prior incarceration, particularly for a crime of moral 

turpitude is a clear and convincing reason for discounting a social security claimant’s 

testimony.”); McKnight v. Comm'r of Social Sec., WL 3773864, at *10 (E .D.Cal. Jul. 17, 

2013) (“An ALJ may rely upon a claimant's convictions for crimes of moral turpitude as 

part of a credibility determination.”) (citation omitted); see also Hardisty v. Astrue, 592 

F.3d 1072, 1080 (9th Cir. 2010) (in ruling on an Equal Access to Justice Act request, the 

Court held the ALJ's credibility determination was substantially justified when it was 

based, among other factors, on the claimant's prior criminal convictions). Plaintiff 

testified that he was incarcerated for violating his probation and was put on probation for 

committing the crime of sexual abuse. Tr. 43. Consequently, the ALJ's consideration of 

Plaintiff's criminal history was proper and supports the ALJ's adverse credibility 

determination. 

 The adverse credibility finding is also supported by the ALJ’s evaluation of the 

medical record. Assessing a plaintiff's testimony regarding the severity of his 

impairments depends on the medical evidence. See Chaudhry v. Astrue, 688 F.3d 661, 

670 (9th Cir. 2012) (“Because the RFC determination must take into account the 

claimant's testimony regarding his capability, the ALJ must assess that testimony in 

conjunction with the medical evidence.”). As discussed above, the medical evidence 

supported the ALJ’s refusal to find Plaintiff disabled based on the records of his treating 

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physicians. That same evaluation applies to the evaluation of Plaintiff’s testimony. 

Considered in tandem, the ALJ’s findings that Plaintiff’s activities of daily living and the 

lack of objective medical evidence of disability undermined his credibility are clear and 

convincing because they were supported by “findings sufficiently specific to permit the 

court to conclude that the ALJ did not arbitrarily discredit [the Plaintiff’s] testimony.” 

Thomas v. Barnhart, 278 F.3d 947, 958 (9th Cir. 2002) (citations omitted). As such, the 

ALJ properly discounted Plaintiff’s subjective complaints. 

IV. Recommendation 

 This Court recommends that the District Court, after its independent review of the 

record, enter an order affirming the decision of the Commissioner and denying benefits.

 Pursuant to 28 U.S.C. §636(b), any party may serve and file written objections 

within fourteen days after being served with a copy of this Report and Recommendation. 

A party may respond to another party's objections within fourteen days after being served 

with a copy thereof. Fed.R.Civ.P. 72(b). No reply to any response shall be filed. See id.

If objections are filed the parties should use the following case number: CV 13-0255-

TUC-JGZ. 

 If objections are not timely filed, then the parties' right to de novo review by the 

District Court may be deemed waived. 

 Dated this 14th day of July, 2014. 

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