Source: s3://data.kl3m.ai/documents/govinfo/USCOURTS/USCOURTS-cand-3_18-cv-06860/USCOURTS-cand-3_18-cv-06860-0/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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UNITED STATES DISTRICT COURT

NORTHERN DISTRICT OF CALIFORNIA

DANIELLE G.,

Plaintiff,

v.

ANDREW M. SAUL,

Defendant.

Case No. 18-cv-06860-JSC 

ORDER RE: CROSS MOTIONS FOR 

SUMMARY JUDGMENT

Re: Dkt. Nos. 16, 17

Plaintiff Danielle G. seeks social security disability benefits for physical and mental 

impairments caused by Borrelia Hermsii (a tick-borne illness), including paralysis in the hands 

and feet, vision problems, neurological issues, rapid heart rate, and low cortisol. (Administrative 

Record (“AR”) 265.) Pursuant to 42 U.S.C. § 405(g), Plaintiff filed this lawsuit for judicial 

review of the final decision by the Commissioner of Social Security (“Commissioner”) denying 

her application for benefits. (Dkt. No. 1.)1 Now before the Court are Plaintiff’s and Defendant’s 

motions for summary judgment.2 (Dkt. Nos. 16 & 17.) Because the decision of the 

Administrative Law Judge (“ALJ”) to deny benefits is supported by substantial evidence and free 

of legal error, the Court DENIES Plaintiff’s motion and GRANTS Defendant’s cross-motion. 

LEGAL STANDARD

A claimant is considered “disabled” under the Social Security Act if she meets two 

requirements. See 42 U.S.C. § 423(d); Tackett v. Apfel, 180 F.3d 1094, 1098 (9th Cir. 1999). 

First, the claimant must demonstrate “an inability to engage in any substantial gainful activity by 

reason of any medically determinable physical or mental impairment which can be expected to 

1 Record citations outside of the administrative record are to material in the Electronic Case File 

(“ECF”); pinpoint citations are to the ECF-generated page numbers at the top of the documents. 

2 Both parties have consented to the jurisdiction of a magistrate judge pursuant to 28 U.S.C. § 

636(c). (Dkt. Nos. 8 & 9.) 

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result in death or which has lasted or can be expected to last for a continuous period of not less 

than 12 months.” 42 U.S.C § 423(d)(1)(A). Second, the impairment or impairments must be 

severe enough that she is unable to do her previous work and cannot, based on her age, education, 

and work experience “engage in any other kind of substantial gainful work which exists in the 

national economy.” 42 U.S.C. § 423(d)(2)(A). To determine whether a claimant is disabled, an 

ALJ is required to employ a five-step sequential analysis, examining: (1) whether the claimant is 

engaging in “substantial gainful activity”; (2) whether the claimant has a severe medically 

determinable physical or mental impairment” or combination of impairments that has lasted for 

more than 12 months; (3) whether the impairment “meets or equals” one of the listings in the 

regulations; (4) whether, given the claimant’s “residual function capacity” (“RFC”) the claimant 

can still do her “past relevant work”’ and (5) whether the claimant “can make an adjustment to 

other work.” Molina v. Astrue, 674 F.3d 1104, 1110 (9th Cir. 2012); see also 20 CFR

§§404.1520(a), 416.920(a). 

An ALJ’s “decision to deny benefits will only be disturbed if it is not supported by 

substantial evidence or it is based on legal error.” Burch v. Barnhart, 400 F.3d 676, 679 (9th Cir. 

2005) (internal quotation marks and citation omitted). “Substantial evidence means such relevant 

evidence as a reasonable mind might accept as adequate to support a conclusion.” Id. (internal 

quotation marks and citation omitted). “Where evidence is susceptible to more than one rational 

interpretation, it is the ALJ’s conclusion that must be upheld.” Id. In other words, if the record 

“can reasonably support either affirming or reversing, the reviewing court may not substitute its 

judgment for that of the Commissioner.” Gutierrez v. Comm’r of Soc. Sec., 740 F.3d 519, 523 

(9th Cir. 2014) (internal quotation marks and citation omitted). However, “a decision supported 

by substantial evidence will still be set aside if the ALJ does not apply proper legal standards.” Id.

BACKGROUND

I. Procedural History

Plaintiff filed a Title II application for social security disability benefits and a Title XVI 

application for supplemental security income in January 2015. (AR 233, 240.) The 

Commissioner first denied Plaintiff’s applications in August 2015, (AR 180), and again denied the 

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applications upon reconsideration in January 2016, (AR 194, 200). Plaintiff then filed a request 

for a hearing before an ALJ. (AR 211.) On July 7, 2017, Plaintiff testified before ALJ Robert 

Freedman. (AR 35-115.) Plaintiff’s counsel was present at the hearing, and Vocational Expert 

(“VE”) Darlene McQuary and Plaintiff’s mother also testified. (AR 35.) 

The ALJ issued Plaintiff an unfavorable decision in November 2017. (AR 12.) The 

decision became final in September 2018 after the Appeals Council denied Plaintiff’s request for 

review. (AR 1.) Plaintiff filed this action thereafter. (Dkt. No. 1.) 

II. Administrative Record

Plaintiff was born on May 29, 1978 and resides in Salinas, California. (AR 233.) She 

asserts that she has been unable to work since October 14, 2013 due to physical and mental 

impairments caused by Borrelia Hermsii, which she contracted after being bitten by a tick in mid2013. (See AR 265.) Plaintiff previously worked as a job placement counselor in 2013, a retail 

store manager from 2008 to 2010, a reservation agent from 2004 to 2005, and a sales 

representative from 2003 to 2004. (AR 266.) 

A. Medical Evaluations and Physician Statements

1. Opinions of Treating Physician Dr. Wright

Dr. D. Craig Wright has been Plaintiff’s treating physician since 2014. (See AR 940.) Dr. 

Wright submitted a medical source statement in August 2015, assessing Plaintiff with chronic 

fatigue and painful paresthesia in her “hands, arms, and feet.” (AR 850.) Dr. Wright opined that 

Plaintiff could carry and lift less than 10 pounds; stand or walk for 30 minutes with a walker, and 

sit for a total of one hour in an eight-hour workday; occasionally reach, handle, finger, feel, 

balance, stoop, kneel, and crouch; and never climb or crawl. (AR 850-51.) Dr. Wright opined that 

Plaintiff’s prognosis was “poor.” (AR 851.) 

Dr. Wright submitted another medical source statement in June 2017, assessing Plaintiff 

with Borrelia Hermsii infection; tick-borne relapsing fever (TBRF); tick-borne illness; chronic 

fatigue syndrome; chronic pain syndrome; and orthostatic hypertension with postural tachycardia. 

(AR 940.) Dr. Wright opined that Plaintiff’s prognosis had improved since 2014, but she “ha[d] 

not returned to normal after her infection.” (Id.) As for work-related limitations, Dr. Wright 

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opined that Plaintiff’s symptoms would cause frequent interference “with the attention and 

concentration required to perform simple work-related tasks.” (AR 941.) Dr. Wright further 

opined that Plaintiff: can sit for 50 minutes at a time for a total of eight hours, stand for one hour, 

and walk for 25 minutes at a time for a total of one hour in an eight-hour workday; must elevate 

her legs 45 degrees for 50% of an eight-hour workday; requires a walker to ambulate due to pain 

and imbalance; can grasp bilaterally 50%, and push, pull, and perform fine manipulation 

bilaterally 5% of an eight-hour workday; can occasionally lift and carry up to 10 pounds; can 

occasionally bend, crawl, and reach above shoulder level but never squat or climb; is mildly 

restricted from exposure to marked temperature and humidity changes; is mildly restricted from 

driving; requires unscheduled 15 minute breaks every two hours; will miss five days of work per 

month and be off-task 20% during the workday. (AR 941-45.) Dr. Wright noted that Plaintiff is 

a recovering alcoholic and “[a]lcohol has been a contributory factor” to Plaintiff’s medical issues 

“in the past.” (AR 945.) 

2. Physical Examination and Opinion by Dr. Hernandez

Dr. Manuel Hernandez is a consultative examining physician who met with Plaintiff on 

June 13, 2015. (AR 839.) Dr. Hernandez’s report notes that Plaintiff’s chief complaint was a 

“[h]istory of exposure to tick-borne disease with ‘neurological issues.’” (Id.) Plaintiff reported 

“trouble walking, maintaining stability, eye hand coordination, [and] memory loss.” (Id.) 

Plaintiff also reported “trouble with ‘any real physical activities,’” but stated that “[s]he is able to 

accomplish her activities of daily living” and “dress, shower, [and] bathe.” (Id.) Dr. Hernandez 

noted that Plaintiff “appear[ed] in no apparent distress,” walked “without difficulty,” and was 

“able to get on and off the exam table without difficulty.” (AR 841.) 

Dr. Hernandez reported normal findings on physical examination and found Plaintiff “alert 

and cooperative” with normal affect, attention, and concentration. (Id.) Plaintiff had full range of 

motion in all joints, her gait was “within normal limits,” she could “balance on her toes,” she did 

not require an assistive device, and she exhibited good muscle tone and full motor strength in all 

extremities with the exception of reduced grip strength in her hands. (AR 842-43.) Dr. Hernandez 

found, however, that Plaintiff could not balance well on her heals and could “perform tandem gait 

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slowly.” (AR 842.) Dr. Hernandez diagnosed Plaintiff with “[h]istory of possible tick-borne 

disease, specifically Borrelia hermsii, which appears stable.” (AR 843.) Dr. Hernandez 

characterized the physical examination results as “benign.” (Id.) 

Dr. Hernandez’s “functional capacity assessment” opined that Plaintiff had no limitations 

“with regards to lifting, carrying, standing, walking or sitting positions.” (Id.) Dr. Hernandez also 

found “no push or pull limitations,” “no postural limitations,” “no visual or communicative 

restrictions,” and “[n]o workplace environmental limitations.” (Id.) The only limitations noted 

were “manipulative limitations” due to bilateral hand weakness. (Id.) 

3. Psychological Examination and Opinion by Dr. Phillips

Dr. Theresa L. Phillips is a consultative examining psychologist who saw Plaintiff on July 

11, 2015. (AR 844-49.) Plaintiff reported no history of prior mental health treatment or 

psychological stressors but reported “physical limitations due to medical problems” associated 

with Borrelia Hermsii. (AR 844-45.) As for her activities of daily living, Plaintiff reported: “She 

is dependent for basic [activities of daily living] on her mom. She can prepare meals. She cannot 

take a bus without supervision. She is unable to make change and shop at the store with a list. 

She can dress and take a shower.” (AR 845.) Plaintiff further reported that she “typically spends 

her day watching TV, doing household chores, and visit[ing] with her family and friends.” (Id.) 

On examination Plaintiff appeared “well groomed with good hygiene,” displayed a 

“positive” attitude, intact motor activity, good eye contact, coherent speech, normal intelligence, 

unimpaired concentration and calculation, good judgment and insight, linear and logical thought 

process, and was alert and oriented to “date, place, time, and situation.” (AR 845-46.) Plaintiff 

also displayed impaired concentration and memory and an anxious and tearful mood. (AR 846.) 

On testing, however, Plaintiff demonstrated a normal range of cognitive functioning. (AR 846-

47.) Dr. Phillips diagnosed Plaintiff with an “unspecified neurocognitive disorder,” and opined 

that Plaintiff’s prognosis was “[f]air with continued medical services” and compliance with 

medication. (AR 848.) Dr. Phillips found no work-related mental limitations except for mild 

impairment with Plaintiff’s “[a]bility to adapt to changes, hazards, or stressors” in the workplace. 

(Id.) 

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4. Non-Examining State Agency Physicians

In August 2015, non-examining state agency physicians reviewed Plaintiff’s medical 

records, the medical opinion evidence, and Plaintiff statements, and determined that her condition 

did “not result in significant limitations in [her] ability to perform basic work activities” and was 

“not severe enough to be considered disabling.” (AR 133, 150.) Two different state agency 

physicians made the same determination upon reconsideration of Plaintiff’s applications in 

December 2015 and January 2016. (See AR 165, 177.)

B. The ALJ’s Decision

On November 22, 2017, the ALJ issued a written decision denying Plaintiff’s application 

and finding that she was not disabled within the meaning of the Social Security Act based on the 

testimony, evidence, and the Social Security Administration’s five-step sequential evaluation 

process for determining disability. (AR 15-28.) 

At step one, the ALJ concluded that Plaintiff had not engaged in substantial gainful activity 

since October 14, 2013. (AR 17.) At step two, the ALJ determined that Plaintiff’s Borrelia 

Hermsii constitutes a severe impairment, and her alcoholism and anxiety were non-severe. (AR 

18-19.) The ALJ determined at the third step that Plaintiff “does not have an impairment or 

combination of impairments that meets or medically equals the severity of one of the listed 

impairments in 20 CFR Part 404, Subpart P, Appendix 1.” (AR 20 (citing 20 C.F.R. §§ 

404.1520(d), 404.1525, 404.1526, 416.920(d), 416.925, and 416.926).) 

Before reaching step four, the ALJ determined that Plaintiff “has the residual functional 

capacity to perform the full range of sedentary work” as defined under 20 C.F.R. §§ 404.1567(a) 

and 416.967(a).3 In making his RFC determination, the ALJ found that Plaintiff’s “medically 

3 The Commissioner defines “sedentary work” as follows: “Sedentary work involves lifting no 

more than 10 pounds at a time and occasionally lifting or carrying articles like docket files, 

ledgers, and small tools. Although a sedentary job is defined as one which involves sitting, a 

certain amount of walking and standing is often necessary in carrying out job duties. Jobs are 

sedentary if walking and standing are required occasionally and other sedentary criteria are met.” 

20 C.F.R. §§ 404.1567(a), 416.967(a). The Commissioner’s interpretive guidance states that 

“‘sedentary work’ represents a significantly restricted range of work,” and “[i]ndividuals who are 

limited to no more than sedentary work by their medical impairments have very serious functional 

limitations.” SSR 96-9p, 1996 WL 374185, at *3 (1996). In addition to lifting and carrying 10 

pounds at a time, the ability to perform the full range of sedentary work generally requires the

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determinable impairments could reasonably be expected to cause the alleged symptoms; however, 

[Plaintiff’s] statements concerning the intensity, persistence, and limiting effects of these 

symptoms are not entirely consistent with the medical evidence and other evidence in the record.” 

(AR 22.) The ALJ cited in support of this finding Plaintiff’s treatment records, her reported 

activities of daily living, and the medical opinion evidence. (AR 22-26.) 

As for the medical opinion evidence regarding Plaintiff’s physical limitations, the ALJ 

afforded “significant weight” to Dr. Hernandez’s June 2015 opinion. (AR 24.) The ALJ found 

that Dr. Hernandez’s opinion was “consistent with and generally well supported by the record as a 

whole” because Dr. Hernandez personally observed and examined Plaintiff and made findings that 

were “congruent with [Plaintiff’s] demonstrably unremarkable physical limitations.” (AR 24.) 

The ALJ afforded “partial weight to the physical assessments of the State agency medical 

consultants at initial review and reconsideration,” finding that “even though they accurately 

account for [Plaintiff’s] generally mild or otherwise unremarkable consultative and other physical 

examinations, they nonetheless fail to consider her exertional limitations in relation to her 

neurological weaknesses and resultant impaired functioning.” (AR 23-24.) The ALJ afforded 

“little weight” to the August 2015 and June 2017 opinions of Plaintiff’s treating physician Dr. 

Wright, finding that neither opinion was consistent with the objective medical evidence because 

they both grossly overstated Plaintiff’s physical limitations and contradicted Dr. Wright’s own 

treatment records. (AR 24-25.)

As for the opinion evidence regarding Plaintiff’s mental limitations, the ALJ gave “great 

weight to the mental assessments of the State agency psychological consultants at initial review 

and reconsideration,” finding the opinions “largely consistent with and supported by the objective 

findings in the record.” (AR 25.) The ALJ afforded “significant weight” to Dr. Phillips’s July 

2015 opinion regarding Plaintiff’s mental limitations because the findings aligned with Plaintiff’s 

“mild mental limitations as noted in the sparse mental health treatment records.” (AR 25.) 

The ALJ also considered the third-party statements from Plaintiff’s mother and afforded 

ability to walk or stand for a total of “no more than about 2 hours,” and sit for a total of “about 6 

hours of an 8-hour workday.” Id. 

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them “little weight.” (AR 25-26.) The ALJ determined that the statements were not (1) consistent 

with the medical opinion evidence or treatment records, (2) accurate as to any “medical signs or 

symptoms,” and (3) unbiased by virtue of the familial relationship. (Id.) 

At step four, the ALJ cited the VE’s hearing testimony and concluded that Plaintiff cannot 

perform her “past relevant work as job developer, retail store manager, sales representative, and 

reservation agent.” (AR 26.) Finally, the ALJ determined at step five that Plaintiff could perform 

other work “that exists in significant numbers in the national economy” based on her “age, 

education, work experience,” and RFC to perform the full range of sedentary work. (AR 27.) In 

sum, the ALJ determined that Plaintiff was not “under a disability, as defined in the Social 

Security Act, from October 14, 2013, through the date of [the ALJ’s] decision.” (AR 27.) 

DISCUSSION

The parties dispute whether the ALJ properly weighed: (1) the medical opinion evidence; 

(2) Plaintiff’s subjective symptom testimony; and (3) third-party statements from Plaintiff’s 

mother. The Court addresses each argument in turn. 

I. Medical Opinion Evidence

A. Legal Standard

In assessing an ALJ’s consideration of the medical opinion evidence, courts “distinguish 

among the opinions of three types of physicians: (1) those who treat the claimant (treating 

physicians); (2) those who examine but do not treat the claimant (examining physicians); and (3) 

those who neither examiner nor treat the claimant (nonexamining physicians).” Lester v. Chater, 

81 F.3d 821, 830 (9th Cir. 1995). “Generally, the opinions of examining physicians are afforded 

more weight than those of non-examining physicians, and the opinions of examining non-treating 

physicians are afforded less weight than those of treating physicians.” Orn v. Astrue, 495 F.3d 

625, 631 (9th Cir. 2007). 

An ALJ may reject the “uncontradicted opinion of a treating or examining doctor” only by 

stating “clear and convincing reasons that are supported by substantial evidence.” Ryan v. 

Comm’r of Soc. Sec., 528 F.3d 1194, 1198 (9th Cir. 2008) (internal quotation marks and citation 

omitted). And “[e]ven if the treating doctor’s opinion is contradicted by another doctor, the 

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Commissioner may not reject this opinion without providing ‘specific and legitimate reasons’ 

supported by substantial evidence in the record for so doing.” Lester, 81 F.3d at 830 (citation 

omitted). That said, “[w]here the opinion of the claimant’s treating physician is contradicted, and 

the opinion of a nontreating source is based on independent clinical findings that differ from those 

of the treating physician, the opinion of the nontreating source may itself be substantial evidence; 

it is then solely the province of the ALJ to resolve the conflict.” Andrews v. Shalala, 53 F.3d 

1035, 1041 (9th Cir. 1995); see also Magallanes v. Bowen, 881 F.2d 747, 751 (9th Cir. 1989) 

(“[T]o the extent that [the nontreating physician’s] opinion rests on objective clinical tests, it must 

be viewed as substantial evidence.”) (alterations in original). Likewise, the opinions of nonexamining physicians may “serve as substantial evidence when the opinions are consistent with 

independent clinical findings or other evidence in the record.” Thomas v. Barnhart, 278 F.3d 947, 

957 (9th Cir. 2002).

“The ALJ need not accept the opinion of any physician, including a treating physician, if 

that opinion is brief, conclusory, and inadequately supported by clinical findings.” Id. Ultimately, 

“[t]he ALJ must do more than offer his conclusions” when rejecting a medical opinion; instead, 

she “must set forth his own interpretations and explain why they, rather than the doctors’, are 

correct.” Embrey v. Bowen, 849 F.2d 418, 421-22 (9th Cir. 1988). Thus, “an ALJ errs when he 

rejects a medical opinion or assigns it little weight while doing nothing more than ignoring it, 

asserting without explanation that another medical opinion is more persuasive, or criticizing it 

with boilerplate language that fails to offer a substantive basis for his conclusion.” Garrison v. 

Colvin, 759 F.3d 995, 1012-13 (9th Cir. 2014). 

B. The ALJ’s Analysis

Because the opinions of treating physician Dr. Wright were contradicted by other medical 

opinion evidence, the ALJ was required to provide “‘specific and legitimate reasons’ supported by 

substantial evidence in the record” for discounting Dr. Wright’s opinions. See Lester, 81 F.3d at 

830 (citation omitted). The ALJ did so. 

1. August 2015 Opinion

In affording little weight to Dr. Wright’s August 2015 opinion, which addressed Plaintiff’s 

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physical limitations, the ALJ noted that the functional limitations expressed in the opinion were

inconsistent with Plaintiff’s treatment records. (AR 24-(citing Exs. 1F-8F, 11F-14F).) The ALJ’s 

determination is supported by substantial evidence; specifically, Plaintiff’s treatment records and

the conflicting opinions of Dr. Hernandez and the State agency physicians. 

On examination in January 2014 Plaintiff reported numbness in the bilateral lower 

extremities and abdomen and on examination demonstrated normal strength and normal gait. (AR 

426.) Dr. Wright ordered a tick-borne disease panel on January 29, 2014 after Plaintiff 

complained of “fatigue, dizziness, palpitations,” and weight loss. (AR 509.) Dr. Wright 

diagnosed Plaintiff with a Borellia Hermsii infection on February 5, 2014, and examined Plaintiff 

10 times between February 5 and 28, 2014, noting, in pertinent part, positive findings of fatigue; 

loss in vision; arthralgias; myalgias; weakness; malaise; confusion; dizziness; difficulty walking; 

and abnormal balance and gait. (AR 489-508, 800-819.) Beginning in late February 2014 until 

April 7, 2014, Plaintiff underwent an intensive course of treatment with antibiotics for her 

infection. (AR 603-814.) 

Dr. Wright examined Plaintiff on June 9 and 16, 2014 and noted “abnormal” findings of 

fatigue and paresthesia in hands; all other findings—including gait and motor strength—were 

normal. (AR 483.) Dr. Wright next examined Plaintiff on July 7 and 17, 2014 and noted 

“abnormal” findings of fatigue, paresthesia of hands and feet, and anxiety. (AR 480.) Dr. Wright 

examined Plaintiff on July 31, 2014 and noted “abnormal” findings of fatigue and paresthesia of 

hands and feet. (AR 479.) Dr. Wright next examined Plaintiff on August 6, 2014 and noted 

“abnormal” findings of fatigue, symptoms related to bronchitis, and paresthesia in hands and feet; 

all other findings were normal. (AR 478.) Dr. Wright examined Plaintiff again on August 20, 

2014, September 12 and 18, 2014, and October 10 and 28, 2014 and noted “abnormal” findings of 

fatigue and paresthesia in hands and feet. (AR 469.) Dr. Wright next examined Plaintiff on 

November 11, 2014 and noted the following abnormal findings: fatigue; painful paresthesia in 

hands and feet; and decreased hand strength. (AR 468.) Dr. Wright’s treatment records from 

November 24, 2014 and January 8, 2015 indicate normal findings on examination. (AR 466-67.) 

Dr. Wright examined Plaintiff again in February 2015; his report indicates normal findings on 

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examination with the exception of “painful paresthesia of the hands.” (AR 464.) 

In April 2015, Plaintiff was the driver in a single-vehicle accident and received treatment 

at the Community Hospital of the Monterey Peninsula’s (“Monterey Hospital”) emergency room. 

(AR 834-38.) On examination Plaintiff exhibited normal range of motion, normal neurological 

and psychological functioning, and denied any complaints. (AR 836-38.) The following month, 

Plaintiff was in another motor vehicle accident and received emergency room treatment at the 

Monterey Hospital for a cervical muscle strain and left knee contusion. (AR 827-31.) Plaintiff 

displayed normal neurological and psychological functioning on examination, (AR 828), and 

normal range of motion, (AR 829). 

Those findings track the opinion of Dr. Hernandez, who physically examined Plaintiff in 

June 2015. Dr. Hernandez’s findings on examination and his medical opinion conflict with Dr. 

Wright’s July 2015 prescription of a wheelchair for Plaintiff’s abnormal gait and his August 2015 

medical source statement regarding Plaintiff’s physical limitations. Because the opinion of Dr. 

Hernandez was based on his independent clinical findings upon examination of Plaintiff, his

opinion alone constitutes substantial evidence in support of the ALJ’s determination. See

Andrews, 53 F.3d at 1041. Thus, “it is then solely the province of the ALJ to resolve the conflict”

between Dr. Hernandez’s and Dr. Wright’s respective opinions. See id. Accordingly, Plaintiff’s 

arguments regarding the weight assigned to the opinions of the non-treating physicians are 

misplaced. (See Dkt. No. 16-1 at 24-26.) The Court is not required to reweigh the medical 

opinion evidence and replace its interpretation for the ALJ’s; instead, the scope of the Court’s 

review is limited to determining whether the ALJ’s decision is supported by substantial evidence 

and free of legal error. It is. 

2. June 2017 Opinion

As for the weight assigned to Dr. Wright’s subsequent medical source statement in June 

2017, the ALJ found that it was “also inconsistent with and unsupported by the record as a whole, 

because it grossly overstates [Plaintiff’s] functional limitations without providing adequate 

support for its conclusions in light of her unremarkable treatment records. (AR 25 (citing Exs. 1F8F, 10F-13F).) The ALJ’s determination is supported by substantial evidence. 

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Dr. Wright examined Plaintiff in February 2016 and noted complaints of fatigue, 

“difficultly walking (due to foot pain), arthralgias (arms, hands and wrists), . . . myalgias,” and 

neurological complaints of “weakness, malaise, confusion, and dizziness.” (AR 858-59.) Dr. 

Wright noted that Plaintiff’s “[p]ainful parasthesias” had improved with medication. (AR 859.) 

Plaintiff again denied “anxiety, depression, feelings of stress and sleep disturbance.” (Id.) On 

examination Plaintiff displayed exhibit normal neurological and psychiatric functioning with the 

exception of “abnormal” balance and gait. (AR 860.) Plaintiff denied “complaints of pain on 

range of motion testing in both hands.” (Id.) 

Dr. Wright examined Plaintiff in August 2016 and his findings track the February 2016 

findings nearly verbatim. Dr. Wright again noted complaints of fatigue, “difficultly walking (due 

to foot pain), arthralgias (arms, hands and wrists), and myalgias.” (AR 853-54.) Dr. Wright also 

noted neurological complaints of “weakness, malaise, confusion, and dizziness.” (Id.) Plaintiff 

denied “anxiety, depression, feelings of stress and sleep disturbance.” (Id.) On examination 

Plaintiff again exhibited normal neurological and psychiatric functioning with the exception of 

“abnormal” balance and gait. (AR 855.) Plaintiff also denied “complaints of pain on range of 

motion testing in both hands.” (Id.) 

In March 2016, Plaintiff began physical therapy at the Monterey Hospital. (AR 873.) The 

physical therapist’s clinical impression noted that Plaintiff displayed “decreased balance, difficulty 

walking, decreased hip [range of motion], decreased strength, gait abnormality, and increased 

difficulty with household management and recreational activities.” (AR 875.) The therapist

opined that Plaintiff’s prognosis was “[e]xcellent.” (AR 876.) Plaintiff was reevaluated a month 

later and she reported that the prescribed exercises were “beneficial,” but Plaintiff “still ha[d] a 

challenge with balance” and descending stairs, as well as “increased right outer leg numbness.” 

(AR 878.) The therapist again opined that Plaintiff’s prognosis was excellent. (AR 880.) 

Plaintiff continued physical therapy and in May 2016 reported “feeling better” and 

“stronger.” (AR 881 (internal quotation marks omitted).) The therapist noted “slow but steady 

progress,” with “setbacks [that] would be expected from her Lyme Disease.” (Id.) The therapist

opined that Plaintiff’s prognosis was excellent. (AR 882.) The following month Plaintiff reported 

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“increased fatigue,” but the examiner noted “improved hip strength since [March 2016],” with 

“4/5 or greater strength throughout bilateral hips.” (AR 911.) A week later Plaintiff reported that 

her gait was “more normal,” but that she continued to have difficulties, “especially with grip 

strength.” (AR 913.) On June 9, 2016, Plaintiff reported decreased pain due “to the start of new 

muscle relaxer.” (AR 916.) A week later Plaintiff reported that “she [was] having a great day,” 

and the therapist noted that Plaintiff “tolerated therapy without complaint of increased pain or 

weakness.” (AR 918.) On June 20, 2016, Plaintiff reported that she was still feeling well, and the 

therapist noted that Plaintiff “tolerated therapy well and did well with balance activities although 

[she] still needs practice.” (AR 920.) Plaintiff was discontinued from the program in July 2016 

after she failed to report for treatment for over 30 days. (AR 922.) 

Dr. Wright treated Plaintiff in March 2017 and his treatment note again tracks nearly 

verbatim the treatment notes from February and August 2016. Dr. Wright noted Plaintiff’s 

complaints of fatigue, “difficultly walking (due to foot pain), arthralgias (arms, hands and wrists), 

and myalgias.” (AR 931-32.) Dr. Wright also noted neurological complaints of “weakness, 

malaise, confusion, and dizziness.” (AR 932.) Plaintiff denied “anxiety, depression, feelings of 

stress and sleep disturbance.” (Id.) On examination Plaintiff again exhibited normal neurological 

and psychiatric functioning with the exception of “abnormal” balance and gait. (AR 933.) 

Plaintiff also denied “complaints of pain on range of motion testing in both hands.” (Id.) 

In June 2017 Dr. Wright submitted his medical source statement regarding Plaintiff’s 

limitations due to her tick-borne illness. (AR 940.) Dr. Wright’s exertional limitations as to 

Plaintiff’s ability to lift/carry 10 pounds at a time, walk and stand for no more than one hour each, 

and sit for 8 hours in a workday track the limitations for sedentary employment. See SSR 96-9p, 

1996 WL 374185, at *3 (noting that in addition to lifting and carrying 10 pounds at a time, the 

ability to perform the full range of sedentary work generally requires the ability to walk or stand 

for a total of “no more than about 2 hours,” and sit for a total of “about 6 hours of an 8-hour 

workday”). Dr. Wright also opined that Plaintiff’s symptoms would cause frequent interference 

“with the attention and concentration required to perform simple work-related tasks.” (AR 941.) 

Dr. Wright further opined, in pertinent part, that Plaintiff must elevate her legs 45 degrees for 

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50% of an eight-hour workday; requires a walker to ambulate due to pain and imbalance; can 

grasp bilaterally 50%, and push, pull, and perform fine manipulation bilaterally 5% of an eighthour workday; and will miss five days of work per month and be off-task 20% during the 

workday. (AR 941-45.) 

As previously discussed, Dr. Wright’s exertional limitations as to Plaintiff’s ability to 

lift/carry, stand/walk, and sit align with the limitations for sedentary employment. Thus, the issue 

is whether substantial evidence supports the ALJ’s determination that the further limitations noted 

in Dr. Wright’s opinion are “inconsistent with and unsupported by the record as a whole, because 

[they] grossly overstate[ ] [Plaintiff’s] functional limitations without providing adequate support.” 

(See AR 25.) Because the treatment records are “susceptible to more than one rational 

interpretation,” the ALJ’s decision “must be upheld.” See Burch, 400 F.3d at 679. 

Dr. Wright examined Plaintiff three times between his 2015 opinion and 2017 opinion—

February and August 2016 and March 2017. (See AR 853, 858, 931.) The only objective 

neurological and psychiatric findings noted in Dr. Wright’s examination reports were “abnormal 

gait.” (See AR 855, 860, 933.) Thus, there are no objective findings to support his opinion that 

Plaintiff’s symptoms would cause frequent interference “with the attention and concentration 

required to perform simple work-related tasks.” (AR 941.) Indeed, the ALJ noted that Dr. 

Phillips’s July 2015 opinion, which the ALJ afforded significant weight, found only mild mental 

limitations on examination. (See AR 25.) Because Dr. Phillip’s opinion was based on her

independent clinical findings upon examination of Plaintiff, that opinion alone constitutes 

substantial evidence in support of the ALJ’s determination. See Andrews, 53 F.3d at 1041. Thus, 

“it is then solely the province of the ALJ to resolve the conflict” between Dr. Phillip’s and Dr. 

Wright’s respective opinions. See id. 

As for Plaintiff’s ability to grasp and perform fine manipulation, Dr. Wright noted no

issues on examination in February and August 2016. Instead, Dr. Wright noted that swelling of 

Plaintiff’s hands had resolved, and Plaintiff had no “complaints of pain on range of motion testing 

in both hands.” (See AR 855, 860, 933.) Further, none of the treatment notes state that Plaintiff 

required an assistive device to ambulate or contain findings to support a limitation regarding 

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Plaintiff’s need to elevate her legs. (See id.) 

In sum, the ALJ’s discussion of Plaintiff’s treatment history, the objective medical 

evidence, and the conflicting opinion evidence constitute “specific and legitimate reasons 

supported by substantial evidence” for assigning little weight to Dr. Wright’s opinions. See 

Lester, 81 F.3d at 830. Further, it bears noting that the ALJ’s RFC determination limiting Plaintiff 

to sedentary work “represents a significantly restricted range of work.” See SSR 96-9p, 1996 WL 

374185, at *3 (“Individuals who are limited to no more than sedentary work by their medical 

impairments have very serious functional limitations.”). In the absence of reversible error, the 

ALJ’s decision must be upheld. See Burch, 400 F.3d at 679 (“Where evidence is susceptible to 

more than one rational interpretation, it is the ALJ’s conclusion that must be upheld.”). 

II. Subjective Symptom Testimony

A. Legal Standard 

The Ninth Circuit has “established a two-step analysis for determining the extent to which 

a claimant’s symptom testimony must be credited.” Trevizo v. Berryhill, 871 F.3d 664, 678 (9th 

Cir. 2017). “First, the ALJ must determine whether the claimant has presented objective medical 

evidence of an underlying impairment which could reasonably be expected to produce the pain or 

other symptoms alleged.” Lingenfelter v. Astrue, 504 F.3d 1028, 1036 (9th Cir. 2007) (internal 

quotation marks and citation omitted). “Second, if the claimant meets the first test, and there is no 

evidence of malingering, the ALJ can reject the claimant’s testimony about the severity of her 

symptoms only by offering specific, clear and convincing reasons for doing so.” Id. (internal 

quotation marks and citation omitted). 

“The clear and convincing standard is the most demanding required in Social Security 

cases.” Moore v. Comm’r of Soc. Sec., 278 F.3d 920, 924 (9th Cir. 2002). Thus, the ALJ cannot 

rely on “general findings” in rejecting a plaintiff’s subjective symptom testimony. Holohan, 246 

F.3d at 1208. That said, the ALJ need not accept the plaintiff’s allegations of pain as true, and 

“may consider inconsistencies either in the claimant’s testimony or between the testimony and the 

claimant’s conduct . . . and whether the claimant engages in daily activities inconsistent with the 

alleged symptoms.” Molina, 674 F.3d at 1112 (internal quotation marks and citations omitted). 

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Further, “the ALJ may discredit a claimant’s testimony when the claimant reports participation in 

everyday activities indicating capacities that are transferable to a work setting.” See id. “Even 

where those activities suggest some difficulty functioning, they may be grounds for discrediting 

the claimant’s testimony to the extent that they contradict claims of a totally debilitating 

impairment.” Id. If the ALJ’s assessment “is supported by substantial evidence in the record, 

[courts] may not engage in second-guessing.” See Thomas, 278 F.3d at 959.

B. ALJ’s Analysis 

Applying the two-step analysis, the ALJ first determined that Plaintiff’s “medically 

determinable impairments could reasonably be expected to cause the alleged symptoms.” (AR 

22.) Because Plaintiff met the first part of the test, the ALJ was required to provide “specific, 

clear and convincing reasons” for rejecting Plaintiff’s testimony regarding the severity of her 

symptoms. Lingenfelter, 504 F.3d at 1036. The ALJ did so. 

In considering Plaintiff’s subjective symptom testimony, the ALJ discussed in detail 

Plaintiff’s function reports, her hearing testimony, and her treatment history. (See AR 20-23.) 

The ALJ found that Plaintiff’s testimony regarding the “intensity, persistence, and limiting effects 

of [her] symptoms” were inconsistent with the medical evidence and other evidence in the record. 

(AR 22.) The ALJ noted that despite Plaintiff’s “allegations of pain and limited functioning, the 

objective medical findings in the record show largely unremarkable findings and symptoms that 

otherwise showed improvement with treatment.” (AR 22.) The ALJ then discussed the medical 

evidence in relation to Plaintiff’s testimony, specifically noting:

[A] computed tomography (CT) scan of the claimant’s brain from 

January 2014 revealed negative findings (Exhibit 2F/18). By the 

time of her internal medicine consultative examination in June 2015, 

the claimant reportedly stated that [her Borrelia Hermsii infection] 

went into a “dormant state” and [she] denied having any fevers or 

history of hospitalizations (Exhibit 8F/2). At that time, the claimant 

reportedly admitted she was able to accomplish her activities of 

daily living, dress, shower, bathe, . . . and handle small instruments 

like scissors, screwdrivers and pliers (Exhibit 8F/2). Moreover, the 

claimant reportedly demonstrated no difficulty walking into the 

examination room or getting on or off the exam table, as well as 

good muscle tone, unremarkable motor strength in all extremities, 

and bilaterally “intact” sensation (Exhibit 8F/3-4; see also Exhibit 

9F/1). As to claimant’s gait, she reportedly displayed a gait that was 

within normal limits that did not require an assistive ambulatory 

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device and she could balance on her toes, while further exhibiting a 

slow tandem gait and a negative Romberg test (Exhibit 8F/4). 

According to her physical therapy treatment records from 2016, the 

claimant reportedly demonstrated improved lower extremity range 

of motion and knee strength, decreased fatigue, and improved hip 

strength (Exhibit 12F/6, 12, 20, 39). By June 2017, Dr. Wright 

noted that the claimant’s condition had improved from 2014, though 

she had concededly “not returned to normal after her infection” 

(Exhibit 14F/5). Thus, the residual functional capacity determined 

herein reasonably accounts for claimant’s Borrelia Hermsii. 

(AR 23.) These reasons are specific, clear, and convincing. Further, and as previously discussed, 

substantial evidence supports the ALJ’s determination that Plaintiff’s treatment records and the 

objective findings on examination do not support totally debilitating limitations associated with 

her condition, but instead demonstrate an ability to perform sedentary work. See Thomas, 278 

F.3d at 959. In sum, the ALJ’s assessment of Plaintiff’s subjective symptom testimony is 

supported by substantial evidence and does not constitute reversible error. 

III. Third-Party Statements

A. Legal Standard

“[L]ay witness testimony as to a claimant’s symptoms or how an impairment affects ability 

to work is competent evidence, and therefore cannot be disregarded without comment.” Nguyen v. 

Chater, 100 F.3d 1462, 1467 (9th Cir. 1996) (emphasis and citations omitted). An ALJ must 

provide “germane reasons for discrediting the testimony of lay witnesses.” Bayliss v. Barnhart, 

427 F.3d 1211, 1218 (9th Cir. 2005). “Inconsistency with medical evidence is one such reason.” 

Id. 

B. ALJ’s Analysis

In December 2015, Plaintiff’s mother provided a third-party function report in support of 

Plaintiff’s claim for disability benefits. (AR 323.) The report details functional limitations that 

track Plaintiff’s own function report. (See AR 305.) Plaintiff’s mother also provided testimony at 

the July 2017 hearing. (See AR 86-92.) The ALJ’s decision addressed the third-party statements

and afforded them little weight, concluding that the statements failed to establish that Plaintiff was 

disabled. (AR 25-26.) In discounting Plaintiff’s mother’s statements, the ALJ noted that they, 

like Plaintiff’s subjective symptom testimony, were “not consistent with the preponderance of the 

opinions and observations by medical doctors in this case.” (AR 26.) That determination is 

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supported by substantial evidence for the reasons previously discussed. Further, the ALJ’s 

rejection of the third-party statements to the extent they were inconsistent with the medical 

evidence constitutes a “germane reason” for discrediting the testimony and does not evince legal 

error. 

***

In sum, the ALJ’s decision is free of legal error and the record “can reasonably support 

either affirming or reversing”; thus, the Court cannot “substitute its judgment for that of the 

Commissioner.” Gutierrez, 740 F.3d at 523 (internal quotation marks and citation omitted). 

CONCLUSION

For the reasons stated above, the Court DENIES Plaintiff’s motion for summary judgment 

and GRANTS Defendant’s cross-motion. 

IT IS SO ORDERED.

Dated: March 16, 2020

JACQUELINE SCOTT CORLEY

United States Magistrate Judge

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