Source: s3://data.kl3m.ai/documents/govinfo/USCOURTS/USCOURTS-azd-2_15-cv-01713/USCOURTS-azd-2_15-cv-01713-0/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 (DIWC)

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WO NOT FOR PUBLICATION 

IN THE UNITED STATES DISTRICT COURT 

FOR THE DISTRICT OF ARIZONA 

Kari Kristi Williamson, 

Plaintiff, 

v. 

Carolyn W. Colvin, 

Defendant.

No. CV-15-01713-PHX-JJT

ORDER 

 At issue is the denial of Plaintiff Kari Kristi Williamson’s Application for 

Supplemental Security Income Benefits by the Social Security Administration (“SSA”) 

under the Social Security Act (“the Act”). Plaintiff filed a Complaint on August 28, 2015, 

seeking judicial review of that denial. (Doc. 1.) The Court has reviewed the 

Administrative Record (Doc. 12, R.) in its entirety, as well as Plaintiff’s Opening Brief 

(Doc. 22, “Pl.’s Br.”), Defendant Social Security Administration Commissioner’s 

Opposition (Doc. 26, “Def.’s Br.”), and Plaintiff’s Reply (Doc. 27, “Pl.’s Reply”), and 

now affirms the Administrative Law Judge’s decision (R. at 8-25), as upheld by the 

Appeals Council (R. at 1-6). 

I. BACKGROUND 

Plaintiff filed an Application for Supplemental Security Income on July 30, 2013 

alleging disability beginning January 23, 2007. (R. at 153.) Plaintiff’s claim was initially 

denied on January 3, 2014. (R. at 53.) Plaintiff requested a hearing, which an 

Administrative Law Judge (“ALJ”) held on January 21, 2015. (R. at 26-51.) On May 7, 

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2015, the ALJ denied Plaintiff’s request for benefits. (R. at 8-25). On July 2, 2015, the 

Appeals Council denied Plaintiff’s request for review of the ALJ’s decision. (R. at 1-6.) 

The present appeal followed. 

The Court has reviewed the record, including hearing testimony and medical 

evidence, in its entirety and provides a short summary below. 

A. Partners in Recovery

Since 2007, Plaintiff has been under the primary care of Dr. Safdar Ali in 

conjunction with Partners in Recovery (a Magellan clinical site), and their records 

comprise the majority of the medical evidence. (E.g., R. at 475.) In July 2011, Dr. Ali 

diagnosed Plaintiff with unspecified mood disorder, posttraumatic stress disorder, and 

borderline personality disorder. (R. at 464.) From 2011 to 2014, Plaintiff saw Dr. Ali no 

fewer than 18 times, and throughout Dr. Ali’s treatment of Plaintiff he assessed various 

symptoms consistent with and related to those diagnoses (R. at 411-15, 430, 433, 438-39, 

448, 454, 457, 460, 464), while often noting improvement and stability (R. at 403, 405-

06, 408-09, 412, 415, 418, 421, 423-27, 429-30, 433-36, 454, 457, 460, 464, 483-84). 

In November 2013, Dr. Ali wrote a medical source statement opining that Plaintiff 

had chronic mental illness resulting in loss of functions including the ability to work and 

be productive. (R. at 475.) On March 25, 2014, Dr. Ali completed a Supplemental 

Questionnaire regarding Plaintiff’s Residual Functional Capacity (“RFC”), finding that 

Plaintiff would have slight limitations in making work-related judgments and interacting 

with the public, moderate limitations in the ability to understand and carry out short, 

simple instructions and interacting with the public, and marked limitations in the ability 

to understand and remember detailed instructions, interact appropriately with supervisors, 

and respond to work pressures and changes in routine work settings. (R. at 476.) Dr. Ali 

further commented that he considered Plaintiff to be seriously mentally ill based on a 

psychiatric disorder and loss of function. (R. at 477.) 

Treatment notes from Partners in Recovery on at least seven other occasions in 

2012 and 2013 show Plaintiff reported lack of energy, depressed mood, anxiety, and 

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moderate severity of symptoms. (R. at 439-520.) During many visits, including her final 

one, Plaintiff denied symptoms of mania, depression, or psychosis, and had no 

overwhelming anxiety, and Plaintiff’s patient notes stated that she was cooperative, 

maintained good eye contact, and exhibited appropriate affect and euthymic mood. (R. at 

500-19.) 

On January 20, 2015, Elise Wise, a Nurse Practitioner at Partners in Recovery 

wrote a general assessment letter diagnosing Plaintiff with unspecified mood disorder and 

posttraumatic stress disorder and noted that her symptoms include the inability to leave 

her house or go to public places. (R. at 521.) 

B. Paradise Valley Hospital

On August 10, 2011, Plaintiff was admitted to Paradise Valley Hospital via its 

Emergency Room in Phoenix, Arizona after attempting to commit suicide by ingesting 

various prescription drugs, including Effexor, Abilify, and Benztropine. (R. at 239-383.) 

Plaintiff stated that she had taken all of the prescription medicine in her possession and 

had attempted suicide in the past. (R. at 250.) After stabilizing, Plaintiff reported that she 

was regretful for the suicide attempt and would not do so again. (R. at 261.) Plaintiff was 

discharged on August 12, 2011, after signing a safety contract to maintain 

communication with counselors after her discharge. (R. at 267.) 

Plaintiff was admitted to Paradise Valley Hospital via its Emergency Room on 

numerous other occasions, including May 14, 2011, October 3, 2011, October 8, 2011, 

November 25, 2011, December 2, 2011, and March 22, 2012, citing throat, chest, or sinus 

pain, often noting depression as well. (R. at 289-317.) Plaintiff was also admitted to 

Paradise Valley Hospital on September 8, 2014, stating that she was experiencing severe 

depression and anxiety and requesting additional anti-depressant medication. (R. at 522-

31.) 

C. State Examining Physicians

On December 17, 2013, Dr. David Yandell reviewed the medical record, 

completed a mental capacities assessment form, and concluded that Plaintiff was not 

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significantly limited in most categories and moderately limited in various work-related 

capacities. (R. at 61-63.) As part of his analysis, Dr. Yandell also completed a Psychiatric 

Review Technique form, concluding that Plaintiff had moderate restrictions of activities 

in daily living, moderate difficulties maintaining social functioning, and moderate 

difficulties in maintaining concentration, persistence or pace. (R. at 59-60.) Dr. Yandell 

found insufficient evidence to assess whether there were episodes of extended 

decompensation. (R. at 59.) Dr. Yandell concluded that Plaintiff was severely limited and 

impacted by her impairments but remained able to perform simple work (R. at 61) and 

simple job tasks on a sustained basis (R. at 63). 

On June 12, 2015, as part of the reconsideration determination, Dr. Stacy 

Koutrakos also reviewed the medical record and completed a mental capacities 

assessment, including a Psychiatric Review Technique form. (R. at 72-77.) Dr. Koutrakos 

reiterated Dr. Yandell’s assessments and also found no significant limitations regarding 

the ability to understand and remember detailed instructions. (R. at 75-76.) 

II. LEGAL STANDARDS 

The district court reviews only those issues raised by the party challenging the 

ALJ’s decision. See Lewis v. Apfel, 236 F.3d 503, 517 n.13 (9th Cir. 2001). The court 

may set aside the Commissioner’s disability determination only if the determination is 

not supported by substantial evidence or is based on legal error. Orn v. Astrue, 495 F.3d 

625, 630 (9th Cir. 2007). Substantial evidence is more than a scintilla, but less than a 

preponderance; it is relevant evidence that a reasonable person might accept as adequate 

to support a conclusion considering the record as a whole. Id. In determining whether 

substantial evidence supports a decision, the court must consider the record as a whole 

and may not affirm simply by isolating a “specific quantum of supporting evidence.” Id. 

As a general rule, “[w]here the evidence is susceptible to more than one rational 

interpretation, one of which supports the ALJ’s decision, the ALJ’s conclusion must be 

upheld.” Thomas v. Barnhart, 278 F.3d 947, 954 (9th Cir. 2002) (citations omitted). 

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To determine whether a claimant is disabled for purposes of the Social Security 

Act, the ALJ follows a five-step process. 20 C.F.R. § 404.1520(a). The claimant bears the 

burden of proof on the first four steps, but the burden shifts to the Commissioner at step 

five. Tackett v. Apfel, 180 F.3d 1094, 1098 (9th Cir. 1999). At the first step, the ALJ 

determines whether the claimant is engaging in substantial gainful activity. 20 C.F.R. 

§ 404.1520(a)(4)(i). If so, the claimant is not disabled and the inquiry ends. Id. At step 

two, the ALJ determines whether the claimant has a “severe” medically determinable 

physical or mental impairment. 20 C.F.R. § 404.1520(a)(4)(ii). If not, the claimant is not 

disabled and the inquiry ends. Id. At step three, the ALJ considers whether the claimant's 

impairment or combination of impairments meets or medically equals an impairment 

listed in Appendix 1 to Subpart P of 20 C.F.R. Pt. 404 (Listing of Impairments). 20 

C.F.R. § 404.1520(a)(4)(iii). If so, the claimant is automatically found to be disabled. Id. 

If not, the ALJ proceeds to step four. Id. At step four, the ALJ assesses the claimant’s 

residual functional capacity and determines whether the claimant is still capable of 

performing past relevant work. 20 C.F.R. § 404.1520(a)(4)(iv). If so, the claimant is not 

disabled and the inquiry ends. Id. If not, the ALJ proceeds to the fifth and final step, 

where he determines whether the claimant can perform any other work based on the 

claimant’s residual functional capacity, age, education, and work experience. 20 C.F.R. 

§ 404.1520(a)(4)(v). If so, the claimant is not disabled. Id. If not, the claimant is disabled. 

Id. 

III. ANALYSIS 

Plaintiff argues that the ALJ erred by: (1) failing to afford appropriate deference to 

the opinion of Plaintiff’s treating psychiatrist, Dr. Ali; (2) improperly rejecting Plaintiff’s 

symptoms testimony without legally sufficient reasoning; and (3) failing to consider the 

entirety of Plaintiff’s limitations in assessing Plaintiff’s RFC. (Pl.’s Br. at 1-2.) 

A. The ALJ Did Not Err in Discounting the Opinion of Dr. Ali 

 Plaintiff contends that the ALJ erred by rejecting the opinion of Dr. Ali. (Pl.’s Br. 

at 11-17.) Defendant argues that the ALJ properly weighed the treating professionals’ 

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assessments, offering specific and legitimate reasons supported by substantial evidence in 

the record for giving partial weight to certain assessments. (Def.’s Br. at 3-8.) 

 An ALJ “may only reject a treating or examining physician’s uncontradicted 

medical opinion based on ‘clear and convincing reasons.’” Carmickle v. Comm’r of Soc. 

Sec., 533 F.3d 1155, 1164 (9th Cir. 2008) (citing Lester v. Chater, 81 F. 3d 821, 830-31 

(9th Cir. 1996)). “Where such an opinion is contradicted, however, it may be rejected for 

specific and legitimate reasons that are supported by substantial evidence in the record.” 

Id.

 In this instance, the ALJ found that the assessments of Plaintiff’s treating 

psychiatrist, Dr. Ali, were contradicted by the objective medical evidence, including Dr. 

Ali’s progress notes, and the assessments of Dr. Yandell and Dr. Koutrakos. (R. at 16-

19.) The Court must therefore examine whether the ALJ provided specific and legitimate 

reasons for discounting the assessments of Dr. Ali, supported by substantial evidence 

when examining the record as a whole. See Carmickle, 533 F.3d at 1164. 

 Rather than rejecting Dr. Ali’s opinion outright, the ALJ gave his generalized 

assessment letter and Supplemental Questionnaire only partial weight. (R. at 16.) 

Primarily, the ALJ found that Dr. Ali’s opinion was not supported by the objective 

medical record, including Dr. Ali’s own progress notes. (R. at 18.) The ALJ supported 

this conclusion with citations to Dr. Ali’s notes that Plaintiff was benefitting from 

medication without adverse effects, that she was very much improved, psychiatrically 

stable, feeling good, exhibited appropriate affect, euthymic mood, good concentration, 

judgment, insight, and memory, and was oriented and alert. (R. at 18.)1

 The ALJ also 

found Dr. Ali’s assessment inconsistent with other progress notes from Partners in 

Recovery and Magellan indicating that Plaintiff was stable, doing well, improving, 

coping with current stressors, and without any symptoms of decompensation. (R. at 18.) 

 

1

 Plaintiff contends that the repeated notations regarding Plaintiff’s improvement were computerized and made without regard to Plaintiff’s actual condition. Plaintiff 

provides no evidence, other than Plaintiff’s own speculation, for this conclusion. 

Accordingly, the Court does not give weight Plaintiff’s speculation in its review of the 

objective medical record. (Pl.’s Br. at 7, n.5, 13.) 

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These findings are consistent with other portions of the medical record in which Plaintiff 

expressed that she was beginning to take courses in nursing (R. at 435, 441, 456) and was 

later contemplating enrolling in DeVry University (R. at 417, 470). Plaintiff also received 

a visit from her daughter who lives in South Dakota (R. at 423), expressed a desire to 

move to India with friends (R. at 429), and repeatedly stated that she was not dealing with 

crises, spoke to her daughter regularly, and was without current stressors (R. at 423, 441, 

444, 483). 

 Further, while a claimant need not be “utterly incapacitated” to be considered 

disabled under the Act, Webb v. Barnhart, 433 F.3d 683, 688 (9th Cir. 2005), Plaintiff’s 

testimony and statements to her treating psychiatrist and staff support the conclusion that 

she had the functional capacity to regularly care for her pets, use a computer, watch 

television, use social media, reconnect with her daughter, keep in touch with friends and 

family, obtain a medical marijuana license, and endeavor to enroll in upper-level 

continuing education. (E.g., R. at 417, 425, 435, 441, 444, 456, 470.) This testimony is 

inconsistent with, for example, the significant limitations Dr. Ali attributed to Plaintiff in 

his November 13, 2013 letter and Supplemental Questionnaire as to RFC. The ALJ 

instead gave greater weight to the opinions of the state agency’s reviewing physicians 

regarding Plaintiff’s RFC because the ALJ found their opinions were not inconsistent 

with the greater objective record, including the weight of Plaintiff’s progress notes and 

Plaintiff’s testimony. (R. at 19.) The Court finds the ALJ provided specific and legitimate 

reasons supported by substantial evidence in determining to give partial weight to Dr. 

Ali’s opinion regarding Plaintiff’s limitations due to her psychiatric impairments and 

assigning greater weight to the reviewing physicians. See Bayliss v. Barnhart, 427 F.3d 

1211, 1216 (9th Cir. 2005). Thus, the ALJ properly considered the opinion of Dr. Ali. 

B. The ALJ Properly Weighed Plaintiff’s Testimony 

Plaintiff also argues that the ALJ erred in his consideration of Plaintiff’s symptom 

testimony. (Pl.’s Br. at 17-20.) In response, Defendant contends that the ALJ gave 

Plaintiff’s testimony proper weight because it was contradicted by objective medical 

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evidence, other portions of Plaintiff’s testimony, and reports of Plaintiff’s daily activities. 

(Def.’s Br. at 8-12.) 

“Where, as here, an ALJ concludes that a claimant is not malingering, and that she 

has provided objective medical evidence of an underlying impairment which might 

reasonably produce the pain or other symptoms alleged, the ALJ may reject the 

claimant’s testimony about the severity of her symptoms only by offering specific, clear 

and convincing reasons for doing so.” Brown-Hunter v. Colvin, 806 F.3d 487, 492-93 

(9th Cir. 2015) (citing Lingenfelter v. Astrue, 504 F.3d 1028, 1036 (9th Cir. 2007)) 

(internal quotation marks omitted). The ALJ’s finding that a claimant is not credible 

“must be sufficiently specific to allow a reviewing court to conclude the adjudicator 

rejected the claimant’s testimony on permissible grounds and did not arbitrarily discredit 

a claimant’s testimony regarding pain.” Id. at 493 (internal citations and quotation marks 

omitted). “General findings are insufficient; rather, the ALJ must identify what testimony 

is not credible and what evidence undermines the claimant’s complaints.” Id. (internal 

citations and quotation marks omitted). 

Plaintiff argues that the ALJ erred in her determination that “the record shows her 

activities and ability to interact with others is less restricted than alleged.” (Pl.’s Br. at 18 

(quoting R. at 16).) The Court disagrees. While the ALJ generally credited Plaintiff’s 

testimony regarding her conditions, the ALJ gave specific, clear, and convincing reasons 

for her determination that the severity of symptoms stemming from those conditions were 

at odds with the medical record and other testimony. In her decision, the ALJ pointed to 

specific medical records and progress notes that were contrary to Plaintiff’s testimony 

regarding the debilitating nature of her symptoms. (R. at 16-17.) The ALJ also pointed to 

Plaintiff’s inconsistent statements regarding her symptoms and side effects from her 

medications. (R. at 17.) Finally, the ALJ noted that Plaintiff’s testimony was controverted 

by her daily activities. (R. at 16-17.) Particularly, the ALJ again noted that Plaintiff 

maintains the ability to travel, keeps social contacts, exhibited good mood and 

interaction, prepared household meals and completed household chores, and has long 

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been contemplating upper-level education that would presumably lead to gainful 

employment, as examples of activities incongruent with Plaintiff’s testimony. (R. at 16.) 

The ALJ also cited Plaintiff’s improved condition, which appeared to be due to the 

elimination of temporary stressors and compliance with treatment. (R. at 17.) The Court 

finds that the ALJ’s extensive review of and citation to the medical record and correlating 

testimony provides specific, clear, and convincing evidence for accepting Plaintiff’s 

diagnoses and symptoms, but not accepting the severity and disabling nature of those 

conditions. 

C. The ALJ Did Not Err in Determining Plaintiff’s Skill Limitations 

Plaintiff lastly argues that that the ALJ’s determination of Plaintiff’s skill 

limitations did not account for acknowledged moderate limitations in Plaintiff’s ability to 

maintain concentration, persistence, or pace. (Pl.’s Br. at 20). Defendant responds that 

substantial evidence supported the ALJ’s assessment of Plaintiff’s skill limitations and 

that her assessment captured the entirety of Plaintiff’s debilities. (Def.’s Br. at 13.) 

Courts affirm an ALJ’s RFC determination where the ALJ has applied the proper 

legal standard and supported her decision by substantial evidence. Bayliss, 427 F.3d at 

1217. Here, in making her RFC determination, the ALJ provided a comprehensive 

assessment of all of Plaintiff’s conditions and symptoms. (See R. at 14-19.) For support 

that Plaintiff retained the ability to maintain concentration, persistence, or pace, the ALJ 

pointed to the Plaintiff’s mental status exams—in which the Plaintiff retained the ability 

to concentrate—and to numerous occasions in Dr. Ali’s notes in which he observed that 

Plaintiff’s ability to concentrate was “good.” (E.g., R. at 403, 406, 409, 412, 415, 421, 

427, 442, 448, 460, 468, 484, 498, 519.) The Court finds that the ALJ’s determination of 

Plaintiff’s RFC is supported by substantial evidence as she took into account all the 

limitations for which there was record support, and thus the Court will not remand on this 

issue. See Carmickle, 533 F.3d at 1162; Bayliss, 427 F.3d at 1217; Stubbs-Danielson v. 

Astrue, 539 F.3d 1169, 1174 (9th Cir. 2008) (“an ALJ’s assessment of a claimant 

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adequately captures restrictions related to concentration, persistence, or pace where the 

assessment is consistent with restrictions identified in the medical testimony”). 

To the extent the ALJ may not have fully considered the issues cited in her RFC 

determination, Plaintiff has not shown that this alleged failure constitutes anything more 

than harmless error. See Tommasetti v. Astrue, 533 F.3d 1035, 1038 (9th Cir. 2008) 

(“[T]he court will not reverse an ALJ’s decision for harmless error, which exists when it 

is clear from the record that the ALJ’s error was inconsequential to the ultimate 

nondisability determination.”) (internal quotation marks omitted). The Court finds that 

the ALJ’s determination of Plaintiff’s RFC is supported by substantial evidence as she 

took into account all the limitations for which there was record support, and thus the 

Court will not remand on this issue. See Carmickle, 533 F.3d at 1162; Bayliss, 427 F.3d 

at 1217. 

D. The Credit-As-True Rule Does Not Apply

Plaintiff asks that the Court apply the “credit-as-true” rule, which were there a 

basis for remand, would result in remand of Plaintiff’s case for payment of benefits rather 

than remand for further proceedings. Treichler v. Comm’r of Soc. Sec. Admin., 775 F.3d 

1090, 1099–102 (9th Cir. 2014); (Pl.’s Br. at 23). Because the Court has found there is no 

basis for remand, neither the ordinary remand rule nor the credit-as-true rule applies. See 

Treichler, 775 F.3d at 1099–102. 

IT IS THEREFORE ORDERED affirming the decision of the Administrative 

Law Judge (R. at 8-25) as upheld by the Appeals Council (R. at 1-6). 

IT IS FURTHER ORDERED directing the Clerk of Court to enter judgment 

accordingly and close this matter. 

Dated this 2nd day of September, 2016. 

Honorable John J. Tuchi 

United States District Judge 

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