Source: s3://data.kl3m.ai/documents/govinfo/USCOURTS/USCOURTS-azd-2_13-cv-01294/USCOURTS-azd-2_13-cv-01294-0/pdf.json

Nature of Suit Code: 864
Nature of Suit: Social Security - SSID Title XVI
Cause of Action: 42:405 Review of HHS Decision (SSID)

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WO 

IN THE UNITED STATES DISTRICT COURT 

FOR THE DISTRICT OF ARIZONA 

Alexia Colter, 

Plaintiff, 

v. 

Carolyn W. Colvin, Acting Commissioner 

of Social Security, 

Defendant. 

No. CV-13-01294-PHX-BSB

ORDER 

 Plaintiff Alexia Colter seeks judicial review of the final decision of the 

Commissioner of Social Security (the Commissioner) denying her application for 

disability insurance benefits under the Social Security Act (the Act). The parties have 

consented to proceed before a United States Magistrate Judge pursuant to 28 

U.S.C. § 636(b), and have filed briefs in accordance with Local Rule of Civil Procedure 

16.1. For the following reasons, the Court affirms the Commissioner’s decision. 

I. Procedural Background 

 On September 29, 2010, Plaintiff applied for disability insurance benefits under 

Titles II and XVI of the Act. (Tr. 13.)1

 Plaintiff originally alleged disability beginning 

August 2008, but later amended the disability onset date to January 2010. (Tr. 167-82, 

46-47.) After the Social Security Administration (SSA) denied Plaintiff’s initial 

application and her request for reconsideration, she requested a hearing before an 

 

1

 Citations to “Tr.” are to the certified administrative transcript of record. (Doc. 16.) 

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administrative law judge (ALJ). After conducting a hearing, the ALJ issued a decision 

finding Plaintiff not disabled under the Act. (Tr. 10-29.) This decision became the final 

decision of the Commissioner when the Social Security Administration Appeals Council 

denied Plaintiff’s request for review. (Tr. 1-6); see 20 C.F.R. § 404.981 (explaining the 

effect of a disposition by the Appeals Council.) Plaintiff now seeks judicial review of 

this decision pursuant to 42 U.S.C. § 405(g). 

II. Administrative Record 

 The record before the Court establishes the following history of diagnosis and 

treatment related to Plaintiff’s health. The record also includes opinions of state agency 

physicians who examined Plaintiff and reviewed the records related to Plaintiff’s 

impairments, but who did not provide treatment. 

A. Treatment Records 

 1. Treatment Related to Headaches 

 After receiving some treatment for migraine headaches (Tr. 373, 648-50), on 

referral from Dr. Veena Gulaya, Plaintiff started seeing neurologist Dr. Nirmal Aryal in 

November 2009. (Tr. 427-29.) Plaintiff reported having headaches “for years” and 

complained of recent tingling in her hands. (Tr. 427.) Plaintiff complained that she had a 

“daily headache” with “photophobia, phonophobia, . . nausea, [and] dizz[ness].” 

(Tr. 427.) On examination, Dr. Aryal found irritated nerves in Plaintiff’s hands and arms 

(Tinel’s and Phalen’s positive). (Tr. 428-29.) She also noted that all of Plaintiff’s 

sensory modalities were within normal limits, she had full motor strength and a normal 

gait. (Id.) Dr. Aryal diagnosed migraine headache, chronic daily headaches, and carpal 

tunnel syndrome, she prescribed Topamax and Relpax and continued use of a wrist splint, 

and she ordered diagnostic tests. (Tr. 427-29.) 

 In January 2010, after Plaintiff’s alleged disability onset date, Plaintiff reported to 

Dr. Aryal that her headache was “much better” and she denied having daily headaches. 

(Tr. 425-26.) Dr. Aryal’s treatment notes contain no indication that Plaintiff had 

ancillary symptoms (such as nausea or dizziness) related to her headaches. (Tr. 425-26.) 

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Plaintiff also reported that her hands were doing better. (Tr. 425.) Dr. Aryal made no 

significant findings on examination of Plaintiff. (Id.) Plaintiff’s gait was normal, her 

“modalities” were within normal limits, and she was alert and oriented. (Id.) Dr. Aryal 

described a recent MRI of Plaintiff’s brain (Tr. 436) as “normal,” recent nerve 

conduction and EMG testing as “normal,” and opined that Plaintiff was “doing very 

well.” (Tr. 425-26.) 

 Electro-diagnostic testing of Plaintiff’s arms and hands conducted in March 2010 

was also normal. (Tr. 474.) There was no evidence of peripheral neuropathy or distal 

nerve impairment. (Id.) In May 2010, Dr. Aryal noted that Plaintiff had a “chronic daily 

headache,” which Plaintiff described as “mild” and said that her headache would “come[] 

and go[],” but it was “not completely resolved.” (Tr. 423.) The treatment notes do not 

indicate that Plaintiff suffered ancillary symptoms related to her headaches. (Tr. 423-24.) 

Plaintiff also reported continued tingling and numbness in her hand. (Id.) On 

examination, Dr. Aryal found that Plaintiff’s sensory modalities were within normal 

limits, she had full strength, her gait was normal, and she was alert and oriented. (Id.) 

 In August 2010, Dr. Aryal again described Plaintiff as having a history of a 

“chronic daily headache.” (Tr. 421.) Plaintiff reported that her headache was “much 

better” and she had one headache per month. (Tr. 421.) The treatment notes do not 

identify any ancillary symptoms related to Plaintiff’s headaches. (Tr. 421-22.) Plaintiff 

reported that her hands were still numb and tingly, but Dr. Aryal noted that a nerve 

conduction study had ruled out carpal tunnel syndrome. (Id.) On examination, Plaintiff 

was alert and oriented, had full strength, her sensory modalities were within normal 

limits, and she had a normal gait. (Tr. 421.) In October 2010, Dr. Aryal noted that 

Plaintiff’s “chronic daily headache seem[ed] to be doing very well on Neurontin,” and 

that her hand symptoms had improved. (Tr. 563-65.) The treatment notes do not 

describe any ancillary symptoms related to Plaintiff’s headaches. (Id.) In December 

2010, Plaintiff’s primary care physician Dr. Olu Orinsile noted that Plaintiff’s headaches 

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had returned, but did not state the frequency of Plaintiff’s headaches or describe any 

ancillary symptoms. (Tr. 588.) 

 In March 2011, Plaintiff reported to Dr. Aryal that her headache was “much 

better” and that her hands had also “improved significantly but [were] still tingly at 

times.” (Tr. 510.) The treatment note does not describe the frequency of Plaintiff’s 

headaches or identify any ancillary symptoms. (Id.) Dr. Aryal described Plaintiff’s 

neurological examination as “stable,” noting that her sensory modalities were within 

normal limits, she had a normal gait, and full strength in her extremities. (Tr. 510-11.) In 

April 2011, Plaintiff reported to Dr. Olinsile that her headaches were worse, but the 

treatment note does not state the frequency of the headaches. (Tr. 580.) 

 In August 2011, Plaintiff reported to Dr. Aryal that her headaches were “much 

better,” and reported ongoing tingling and numbness in her hands. (Tr. 679.) The 

treatment note does not indicate the frequency of Plaintiff’ headaches and does not 

indicate that Plaintiff had any ancillary symptoms when she had a headache. (Id.) 

Plaintiff’s neurological examination was unremarkable. (Tr. 679-80.) On examination, 

Plaintiff was alert and oriented, had full strength, her sensory modalities were within 

normal limits, and she had a normal gait. (Tr. 680.) Dr. Aryal did not make a specific 

diagnosis related to Plaintiff’s reported tingling and numbness in her hands. (Tr. 679-

680.) In October 2011, Plaintiff reported to Dr. Aryal that her headaches “were much 

better,” but she continued to experience tingling and numbness in her hands. (Tr. 676.) 

The treatment note does not state the frequency of Plaintiff’s headaches or identify any 

ancillary symptoms. (Tr. 676-77.) On examination, Plaintiff was alert and oriented, her 

sensory modalities were within normal limits, she had full strength, and a normal gait. 

(Tr. 676.) 

 On January 17, 2012, Plaintiff reported to Dr. Aryal that her headaches were 

worse and she was having daily headaches. (Tr. 673.) Plaintiff said she was under a lot 

of stress following her breast cancer diagnosis. (Id.) She was scheduled for surgery the 

next day. (Id.) The treatment note does not describe any ancillary symptoms related to 

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Plaintiff’s headaches. (Tr. 673-74.) Plaintiff reported bilateral tingling and numbness in 

her lower extremities. (Tr. 673.) On examination, Plaintiff was alert and oriented, her 

sensory modalities were within normal limits, she had full strength in her extremities, and 

a normal gait. (Tr. 674.) 

 2. Treatment Related to Plaintiff’s Knee, Back, and Joint Pain

 On referral from Dr. Gulaya, in November 2009, Plaintiff saw physician assistant 

(PA) Brian Nelson for knee, back, and hip pain and stiffness. (Tr. 468-70.) PA Nelson 

assessed osteoarthritis of the hip, collagen vascular disease, and patellofemoral 

syndrome. (Tr. 469.) In November 2009, X-rays of Plaintiff’s hips showed “mild 

degenerative changes” (Tr. 478), and X-rays of Plaintiff’s knees showed evidence of 

degenerative osteoarthritis more severe on the right than the left. (Tr. 477.) A November 

2009 X-ray of Plaintiff’s lumbar spine showed “mild degenerative disc disease at L2-3.” 

(Tr. 476.) 

 After the January 2010 alleged onset of disability, Plaintiff saw PA Nelson every 

few months for joint pain, and he diagnosed osteoarthritis. At these visits PA Nelson 

made findings on examination, including tenderness of the spine and cracking and 

swelling of the knee, and he prescribed pain medication. (Tr. 465-67 (January 2010), 

461-64 (March 2010), 458-60 (June 2010), 455-57 (September 2010), 451-54 (October 

2010), 568-70 (December 2010).) At several subsequent visits in the fall of 2010, PA 

Nelson recommended that Plaintiff consult a physical therapist, but the record does not 

include any physical therapy records. (Tr. 451-54, 568-70.) 

 X-rays of Plaintiff’s knees in October 2010 showed moderate osteoarthritis in her 

right knee and mild to moderate osteoarthritis in her left knee. (Tr. 472.) In October 

2010, An X-ray and MRI of Plaintiff’s spine showed “mild degenerative disc disease” in 

the lumbar spine (Tr. 471), and “mild spondylitic disease at L4-L5 and L5-S1.” 

(Tr. 602.) In October 2010, X-rays of Plaintiff’s sacroiliac joints were “normal.” 

(Tr. 473.) 

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 Plaintiff continued seeing PA Nelson in 2011. PA Nelson continued to make the 

same findings on examination — including pain, swelling, and crepitus in the knees, pain 

on motion of the hip, and tenderness on palpation to the lumbrosacral spine — and 

prescribed pain medication for osteoarthritis of the hip and knee. (Tr. 565-67 (March 

2011), 726-28 (June 2011), 721-25 (August 2011), 716-20 (November 2011).) At these 

appointments, PA Nelson recommended a consultation to consider epidural injections for 

Plaintiff’s back pain. (Tr. 567, 719, 723, 728.) There are no medical records 

documenting that Plaintiff received these injections. However, the record reflects that 

Plaintiff had Supartz knee injections. (Tr. 451-53.) 

 During 2010, Plaintiff also saw her primary care provider Dr. Onisile for joint 

pain. (Tr. 590.) Dr. Onisile noted that Plaintiff reported neck, shoulder, back, and hip 

pain. (Id.) He also noted right hand weakness with occasional loss of grip. (Id.) On 

examination, Dr. Onisile found tenderness in Plaintiff’s cervical and lumbar spine and 

sacroiliac joint. (Id.) He also noted pain with lumbar flexion, right hip rotation, and right 

shoulder adduction. Plaintiff had a positive straight-leg test and mild tenderness of her 

right forearm and wrist. (Tr. 590.) In November 2010, Dr. Onisile’s examination was 

essentially the same, but he also found 11/18 trigger points and noted radiating pain into 

Plaintiff’s upper and lower extremities. (Tr. 589.) During 2011, Plaintiff continued 

seeing Dr. Onisile who noted that Plaintiff reported back and joint pain at some visits. 

(Tr. 578, 579, 584, 585, 586, 587.) 

 On July 19, 2011, Plaintiff saw rheumatologist Dr. Michael Fairfax for low back 

pain and general musculoskeletal pain. (Tr. 662.) On examination, Dr. Fairfax found no 

musculoskeletal tenderness or deformity, no muscle weakness or gross neurologic deficit, 

and no synovitis on joint examination. (Id.) However, he noted a positive ANA.2

 (Id.) 

 

2

 A positive ANA reading might indicate that a patient has an autoimmune disease 

such as lupus, however, a positive reading alone does not indicate such a diagnosis. A relatively small percentage of such patients actually have an autoimmune or connective 

tissue disease. See American College of Rheumatology, Antinuclear Antibodies (ANA), 

https://www.rheumatology.org/Practice/Clinical/Patients/Diseases_And_Conditions/Anti

nuclear_Antibodies_(ANA). (last visited February 12, 2015). 

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In September 2011, Dr. Fairfax diagnosed low back pain (lumbago) and abnormal blood 

chemistry; he prescribed medication (Plaquenil) to treat a possible autoimmune illness or 

connective tissue disorder. (Tr. 661.) Plaintiff followed up with a nurse practitioner in 

December 2011. (Tr. 659.) In November 2011, X-rays of Plaintiff’s hands showed a 

small foreign body on her right thumb but otherwise no significant osteoarthritis. 

(Tr. 740.) In November 2011 X-rays of Plaintiff’s feet and knees showed degenerative 

changes consistent with osteoarthritis (Tr. 741), and moderate osteoarthritis in Plaintiff’s 

“medial right knee.” (Tr. 742.) 

 3. Treatment Related to Plaintiff’s Breast Cancer 

 In November 2011, a biopsy taken from a lump in Plaintiff’s breast was positive 

for breast cancer. (Tr. 697.) Plaintiff had a mastectomy and chemotherapy in late 2011 

and early 2012. (Tr. 690-92, 755-75, 785-96.) Plaintiff also had follow-up surgery 

related to the mastectomy. (Tr. 745, 749.) Plaintiff had follow-up visits through March 

2012. (Tr. 755-75, 785-96.) 

B. Medical Opinion Evidence 

 1. Kathleen Handal 

In December 2010, as part of the administrative proceeding, state agency 

physician Dr. Kathleen Handal reviewed Plaintiff’s medical records and completed a 

Physical Residual Functional Capacity (RFC) Assessment. (Tr. 267-69.) Dr. Handal 

opined that Plaintiff could occasionally lift twenty pounds and frequently lift ten pounds, 

that she could stand or walk four hours in an eight-hour workday, and that she could sit 

for six hours in an eight-hour workday. (Tr. 267.) She also found that Plaintiff could 

frequently balance and stoop, occasionally kneel, crouch, and climb ramps or stairs, but 

that she could never crawl or climb ladders, ropes, and scaffolds. (Tr. 267-68.) She 

further found that Plaintiff should avoid hazards (heights and machinery), and 

concentrated exposure to extreme heat, wetness, humidity, and vibration. (Id.) She also 

found that Plaintiff should avoid moderate exposure to noise and fumes, odors, dust, 

gases, and poor ventilation. (Tr. 268.) 

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 Dr. Handal explained that Plaintiff’s obesity, osteoarthritis of the knee, and mild 

degenerative disease in her back and hips resulted in her postural limitations, and that her 

obesity, neurological records, and prescribed medications resulted in her environmental 

limitations. (Tr. 268.) 

 2. Michael Keer 

 On June 1, 2011, as part of the administrative proceeding, state agency physician 

Dr. Michael Keer reviewed Plaintiff’s medical records and completed a Physical RFC 

Assessment. (Tr. 613-15.) Dr. Keer opined that Plaintiff had the same work-related 

limitations as those outlined in Dr. Handal’s opinion. (Tr. 613-15.) Dr. Keer also found 

Plaintiff unlimited in her ability to use hand or foot controls. (Tr. 613.) Dr. Keer 

explained that Plaintiff’s obesity, osteoarthritis of the knee, and degenerative changes in 

her back and hips supported the identified postural limitations. (Tr. 614.) He also 

explained that Plaintiff’s neurologic examinations supported his findings of 

environmental limitations. (Tr. 615.) Dr. Keer also noted that the additional medical 

records did not show a worsening of any of Plaintiff’s conditions. (Id.) 

 3. Michael Fairfax 

 On March 8, 2012, Plaintiff’s treating physician, Dr. Fairfax completed a Medical 

Assessment of Ability to do Work-Related Physical Activity assessing Plaintiff’s workrelated physical limitations. (Tr. 783-84.) Dr. Fairfax opined that Plaintiff could not 

work on a regular and consistent basis due to her pain and fatigue. (Tr. 784.) He found 

that Plaintiff could sit between three to four hours in an eight-hour day, lift and carry 

between fifteen and twenty pounds, stand or walk less than two hours in an eight-hour 

day, and occasionally use her hands and feet (with frequent reaching). (Tr. 783.) He also 

found that Plaintiff could occasionally bend, climb, stoop, balance, and crouch, but never 

crawl or kneel. (Id.) He further found that Plaintiff should avoid unprotected heights, 

and she was moderately limited in her exposure to marked changes in temperature, 

humidity, and moving machinery, and she was mildly restricted in her ability to drive and 

her exposure to dust, fumes, and gases. (Tr. 784.) Dr. Fairfax described Plaintiff’s pain 

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and fatigue as “moderately severe,” and noted those symptoms could reasonably be 

expected to result from objective clinical or diagnostic findings in the record. (Tr. 784.) 

 4. Nirmal Aryal 

 In March 8, 2012, Plaintiff’s treating neurologist Dr. Aryal completed a Medical 

Assessment of Ability to do Work-Related Physical Activities assessing Plaintiff’s workrelated limitations. (Tr. 747-48.) Dr. Aryal opined that Plaintiff was “unable to work at 

this time,” noting that Plaintiff reported having headaches on a daily basis for one to three 

hours with no relief and also had several ancillary symptoms (shortness of breath, 

dizziness, fatigue, and pain). (Tr. 747.) Dr. Aryal opined that Plaintiff should avoid 

unprotected heights and moving machinery. (Id. at 748.) She also found Plaintiff 

moderately limited in her exposure to marked changes in temperature, humidity, and 

dust, fumes, and gases. (Tr. 748.) She opined that Plaintiff was mildly limited in her 

ability to drive. (Id.) Dr. Aryal described Plaintiff’s restrictions as “moderate,” meaning 

that they affected but did not preclude her ability to function. (Id.) Dr. Aryal also stated 

her opinion regarding Plaintiff’s headaches was based on Plaintiff’s reports, and that the 

limitations identified in her assessment could not “reasonably be expected to result from 

objective criterial or diagnostic findings” documented in Plaintiff’s medical record. 

(Tr. 747-48.) 

 5. Brian Nelson 

 On April 12, 2012, Plaintiff’s treating PA Brian Nelson wrote a letter “to whom it 

may concern,” stating that Plaintiff’s functional impairment caused by chronic 

musculoskeletal pain could not be measured objectively and would have to be based on 

Plaintiff’s reports of pain and fatigue (noting that Plaintiff consistently reported her 

symptoms). (Tr. 893-94.) He also noted that he could not determine the impact of 

Plaintiff’s symptoms in relation to Plaintiff’s activities, including work. (Tr. 893.) 

III. Administrative Hearing Testimony

 Plaintiff was in her early forties at the time of the administrative hearing and the 

Commissioner’s decision. (Tr 45.) She had a high school education and some college. 

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(Tr. 45, 48.) Plaintiff’s past relevant work included caregiver, cashier/checker, office 

clerk, and receptionist. (Tr. 63.) Plaintiff testified that she was unable to work due to 

knee and back pain, hand problems, migraine headaches, and breast cancer. (54-55, 59, 

61.) 

 When describing her daily activities, Plaintiff said that she got up, took her 

medication, showered, got dressed, said hello to her family, and then laid down in her 

room “pretty much all day.” (Tr. 51-52.) Plaintiff also testified that she helped watch her 

grandchildren a few hours per day, and that the only housework she did was the dishes. 

(Tr. 49.) She also testified that she occasionally helped her nineteen-year-old son, who 

received disability benefits. (Tr. 51.) Plaintiff said that she could sit for one hour, stand 

for one hour, walk one-half block, and lift ten pounds. (Tr. 50.) Plaintiff said that she 

had daily tingling and numbness in her hands, which made it difficult to write and she 

“sometimes” had difficulty grasping. (Tr. 55.) Plaintiff described daily pain in her knees 

and daily headaches lasting an hour or more, and stated that her pain was getting worse. 

(Tr. 55-56, 58-59.) At the time of the hearing, Plaintiff was undergoing chemotherapy 

every two weeks for breast cancer. (Tr. 52-53.) 

 Vocational expert Marilyn Kinnier also testified at the hearing. (Tr. 62-72.) She 

testified that an individual with the limitations adopted by the ALJ could perform 

Plaintiff’s past work as an office clerk, cashier/checker, or collections representative.3

 

(Tr. 63-64.) The vocational expert also testified that such an individual could perform 

other work in the economy, such as a sales attendant, ticket taker, or photocopy machine 

operator. (Tr. 64-65.) In response to questions from Plaintiff’s attorney, the vocational 

expert testified that an individual with the limitations identified by Dr. Fairfax, or who 

needed to lie down on a regular basis, leave work early, or miss work three to four times 

a month, would be unable to sustain regular employment. (Tr. 67, 71-72, 65.) 

/ / / 

 

3

 The ALJ’s assessment of Plaintiff’s limitations is set forth below in Section IV. 

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IV. The ALJ’s Decision

 A claimant is considered disabled under the Social Security Act if she is unable 

“to engage in any substantial gainful activity by reason of any medically determinable 

physical or mental impairment which can be expected to 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); see also 42 U.S.C. § 1382c(a)(3)(A) (nearly identical standard for 

supplemental security income disability insurance benefits). To determine whether a 

claimant is disabled, the ALJ uses a five-step sequential evaluation process. See 20 

C.F.R. §§ 404.1520, 416.920. 

A. The Five Step Sequential Evaluation Process 

 In the first two steps, a claimant seeking disability benefits must initially 

demonstrate (1) that she is not presently engaged in a substantial gainful activity, and 

(2) that her disability is severe. 20 C.F.R. § 404.1520(a)(4)(i) and (ii). If a claimant 

meets steps one and two, there are two ways in which she may be found disabled at steps 

three through five. At step three, she may prove that her impairment or combination of 

impairments meets or equals an impairment in the Listing of Impairments found in 

Appendix 1 to Subpart P of 20 C.F.R. Part 404. 20 C.F.R. § 404.1520(a)(4)(iii). If so, the 

claimant is presumptively disabled. If not, the ALJ determines the claimant’s RFC. At 

step four, the ALJ determines whether a claimant’s RFC precludes her from performing 

her past work. 20 C.F.R. § 404.1520(a)(4)(iv). If the claimant establishes this prima 

facie case, the burden shifts to the government at step five to establish that the claimant 

can perform other jobs that exist in significant number in the national economy, 

considering the claimant’s RFC, age, work experience, and education. 20 C.F.R. 

§ 404.1520(a)(4)(v). If the government does not meet this burden, then the claimant is 

considered disabled within the meaning of the Act. 

B. The ALJ’s Application of the Five Step Evaluation Process 

 Applying the five-step sequential evaluation process, the ALJ found that Plaintiff 

had not engaged in substantial gainful activity during the relevant period. (Tr. 15.) At 

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step two, the ALJ found that Plaintiff had the following severe impairments, “breast 

cancer, headaches, alopecia, obesity, bilateral knee osteoarthritis, polyarthritis, and 

degenerative disc disease of the lumbar spine (20 C.F.R. § 404.1520(c) and 416.920(c)).” 

(Id.) At the third step, the ALJ found that the severity of Plaintiff’s impairments did not 

meet or medically equal the criteria of an impairment listed in 20 C.F.R. Part 404, 

Subpart P, Appendix 1. (Tr. 17.) The ALJ next concluded that Plaintiff retained “the 

residual functional capacity to perform light work as defined in 20 C.F.R. § 404.1567(a) 

and 416.967(b) . . . .” (Id.) The ALJ further found that Plaintiff was limited to 

occasional kneeling, crouching, crawling, and climbing ramps and stairs, and that “she 

must avoid occupations that require crawling or climbing on ladders, ropes, and 

scaffolds,” and “must avoid exposure to fumes, temperature extremes, vibration, and 

extreme dampness and humidity.” (Id.) The ALJ found that Plaintiff “could not be 

exposed to dangerous machinery and unprotected heights.” (Id.) 

 At step four, the ALJ concluded that Plaintiff could perform her past relevant work 

as an office clerk and collections representative. (Tr. 21.) Alternatively, at step five, the 

ALJ found that considering Plaintiff’s age, education, work experience, and RFC, she 

could perform other jobs that existed in significant numbers in the national economy. 

(Id.) The ALJ concluded that Plaintiff had not been disabled within the meaning of the 

Act from January 1, 2010 through the date of decision, May 4, 2012. (Tr. 24.) 

V. Standard of Review 

 The district court has the “power to enter, upon the pleadings and transcript of 

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

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

court reviews the Commissioner’s final decision under the substantial evidence standard 

and must affirm the Commissioner’s decision if it is supported by substantial evidence 

and it is free from legal error. Smolen v. Chater, 80 F.3d 1273, 1279 (9th Cir. 1996); 

Ryan v. Comm’r of Soc. Sec. Admin., 528 F.3d 1194, 1198 (9th Cir. 2008). 

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 Even if the ALJ erred, however, “[a] decision of the ALJ will not be reversed for 

errors that are harmless.” Burch v. Barnhart, 400 F.3d 676, 679 (9th Cir. 2005). 

Substantial evidence means more than a mere scintilla, but less than a preponderance; it 

is “such relevant evidence as a reasonable mind might accept as adequate to support a 

conclusion.” Richardson v. Perales, 402 U.S. 389, 401 (1971) (citations omitted); see 

also Webb v Barnhart, 433 F.3d 683, 686 (9th Cir. 2005). In determining whether 

substantial evidence supports a decision, the court considers the record as a whole and 

“may not affirm simply by isolating a specific quantum of supporting evidence.” Orn v.

Astrue, 495 F.3d 625, 630 (9th Cir. 2007) (internal quotation and citation omitted). 

 The ALJ is responsible for resolving conflicts in testimony, determining 

credibility, and resolving ambiguities. See Andrews v. Shalala, 53 F.3d 1035, 1039 (9th 

Cir. 1995). “When the evidence before the ALJ is subject to more than one rational 

interpretation, [the court] must defer to the ALJ’s conclusion.” Batson v. Comm’r of Soc.

Sec. Admin., 359 F.3d 1190, 1198 (9th Cir. 2004) (citing Andrews, 53 F.3d at 1041). 

VI. Plaintiff’s Claims 

 Plaintiff asserts that the ALJ erred by rejecting the opinions of treating physicians 

Dr. Fairfax and Dr. Aryal. (Doc. 19 at 13.) She also argues that the ALJ erred in 

discounting her symptom testimony. (Id. at 23.) In response, the Commissioner argues 

that the ALJ’s decision is free from legal error and is supported by substantial evidence in 

the record. (Doc. 20.) 

 A. Weight Assigned to Medical Source Opinions 

 Plaintiff argues that the ALJ erred in weighing the medical source opinion 

evidence. (Doc. 19 at 13-23.) In weighing medical source evidence, the Ninth Circuit 

distinguishes between three types of physicians: (1) treating physicians, who treat the 

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

(3) non-examining physicians, who neither treat nor examine the claimant. Lester v. 

Chater, 81 F.3d 821, 830 (9th Cir. 1995). Generally, more weight is given to a treating 

physician’s opinion. Id. The ALJ must provide clear and convincing reasons supported 

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by substantial evidence for rejecting a treating or an examining physician’s 

uncontradicted opinion. Id.; Reddick v. Chater, 157 F.3d 715, 725 (9th Cir. 1998). An 

ALJ may reject the controverted opinion of a treating or an examining physician by 

providing specific and legitimate reasons that are supported by substantial evidence in the 

record. Bayliss v. Barnhart, 427 F.3d 1211, 1216 (9th Cir. 2005); Reddick, 157 F.3d at 

725. 

 Opinions from non-examining medical sources are entitled to less weight than 

opinions from treating or examining physicians. Lester, 81 F.3d at 831. Although an 

ALJ generally gives more weight to an examining physician’s opinion than to a nonexamining physician’s opinion, a non-examining physician’s opinion may nonetheless 

constitute substantial evidence if it is consistent with other independent evidence in the 

record. Thomas v. Barnhart, 278 F.3d 947, 957 (9th Cir. 2002). When evaluating 

medical opinion evidence, the ALJ may consider “the amount of relevant evidence that 

supports the opinion and the quality of the explanation provided; the consistency of the 

medical opinion with the record as a whole; [and] the specialty of the physician providing 

the opinion . . . .” Orn, 495 F.3d at 631. 

 1. Weight Assigned to Dr. Fairfax’s Opinion 

 Dr. Fairfax opined that Plaintiff could not work on a regular and consistent basis 

due to chronic joint pain and fatigue, and he described Plaintiff’s limitations as 

moderately severe. (Tr. 783.) He found Plaintiff limited to sitting less than four hours 

per day and standing or walking less than two hours per day. (Tr. 783-84.) He also 

found postural and environmental limitations. (Id.) Dr. Fairfax opined that Plaintiff was 

limited to occasional use of her hands and feet. (Id.) 

 Although Dr. Fairfax was a treating physician, his opinion is not entitled to 

controlling weight because the reviewing physicians’ opinions discussed in Section II.B.I 

and II.B.2 were inconsistent with Dr. Fairfax’s conclusions. See 20 C.F.R. § 1527(c)(2) 

and SSR 96-2p, 1996 WL 374188, at *2 (discussing when treating physician opinions 

will be given controlling weight); see also Bayliss, 427 F.3d at 1216 (citing Lester, 81 

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F.3d at 830-31 (discussing applicable standards for evaluating treating physicians’ 

opinions)). Accordingly, the ALJ properly assigned Dr. Fairfax’s opinion less weight by 

providing specific and legitimate reasons, which are supported by substantial evidence in 

the record. See Bayliss, 427 F.3d at 1216. 

 The ALJ discussed the medical record (Tr. 17-18), and properly discounted 

Dr. Fairfax’s opinion as inconsistent with the record and his treatment notes. (Tr. 19.) 

See Batson, 359 F.3d at 1195 (an ALJ may discredit treating physicians’ opinions that are 

unsupported by the record as a whole or by objective medical findings). Plaintiff argues 

that the ALJ failed to sufficiently identify the evidence that was inconsistent with 

Dr. Fairfax’s opinion. (Doc. 19 at 14-15.) However, the ALJ’s statement that 

Dr. Fairfax’s opinion was inconsistent with the medical record opinion is reasonably 

construed to refer to the evidence the ALJ discussed as part of her RFC analysis, which 

includes citation to various medical records that do not support the limitations Dr. Fairfax 

identified. (Tr. 17-18.) 

 Dr. Fairfax stated that his opinion was based on Plaintiff’s chronic joint pain and 

fatigue, but the objective evidence, which the ALJ cited (Tr. 17-18), showed that 

Plaintiff’s osteoarthritis was mild to moderate. (Tr. 476-78, 471-73, 740-42.) 

Additionally, while blood work from Dr. Fairfax’s office indicated that Plaintiff might 

have an autoimmune or connective tissue disorder (Tr. 662), Dr. Fairfax did not 

specifically identify such a disorder as the basis for his opinion. (Tr. 783-84.) In 

addition, Dr. Fairfax’s treatment notes, and the notes from his nurse practitioner, do not 

include any notations regarding fatigue. (Tr. 659, 661, 662.) 

 The ALJ also discounted Dr. Fairfax’s opinion because it was on a checkbox form 

without further explanation. (Tr. 19.) This is a specific and legitimate reason for 

assigning little weight to Dr. Fairfax’s opinion. See 20 C.F.R. § 404.1527(c)(3) (“The 

better an explanation a source provides for an opinion, the more weight we will give that 

opinion.”). The record reflects that Dr. Fairfax saw Plaintiff twice (Tr. 661-63), and that 

a nurse practitioner in his office saw Plaintiff once (Tr. 659), before Dr. Fairfax assessed 

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Plaintiff’s functional abilities. Thus, Dr. Fairfax’s assessment is supported by few 

clinical notes and is unlike a situation in which a physician’s otherwise brief opinion 

could be considered supported by a lengthy treatment history. See Bray v. Comm’r of 

Soc. Sec. Admin., 554 F.3d 1219, 1228 (9th Cir. 2009) (an 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”). Accordingly, the record 

supports the ALJ’s conclusion that Dr. Fairfax’s opinion was brief, conclusory, and 

inadequately supported by explanatory clinical findings, and the ALJ did not err in giving 

Dr. Fairfax’s opinion little weight on that basis. See Holohan v. Massanari, 246 F.3d 

1195, 1202 (9th Cir. 2001) (“[T]he regulations give more weight to opinions that are 

explained than to those that are not.”). 

 Additionally, substantial evidence in the record, discussed in Section II.A, 

supports the ALJ’s decision to discount Dr. Fairfax’s opinions as unsupported by the 

record. Although the record includes evidence that Plaintiff had pain, crepitus and 

swelling in her knees, pain on motion in her hip, and tenderness in her spine (Tr. 465-67, 

461-64, 458-60, 455-57, 451-54, 565-67, 659, 716-20, 726-28), there is also evidence that 

Plaintiff was in no acute distress, had intact sensation, normal motor function, full 

strength in her extremities, and a normal gait. (Tr. 410, 423, 510, 680, 677, 674). 

Treatment notes from Dr. Fairfax’s office indicate that Plaintiff reported joint pain and 

stiffness (Tr. 659, 661, 662), and crepitus in the knees (Tr. 659), but on examination she 

was found to have “mild synovitis” in the joints of her hand or no synovitis (Tr. 659, 

662), no musculoskeletal weakness or gross neurologic deficit (Tr. 662), intact range of 

motion in her upper extremities (Tr. 659), and no postural limitations. (Tr. 659, 661.) 

Considering the record as a whole, the ALJ rationally concluded that the medical record 

did not support the limitations that Dr. Fairfax identified, and the Court “must uphold the 

ALJ’s decision where the evidence is susceptible to more than one rational 

interpretation.” Magallanes, 881 F.2d at 750; see Batson, 359 F.3d at 1198. 

/ / / 

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 2. Weight Assigned to Dr. Aryal’s Opinion 

Treating neurologist Dr. Aryal opined that Plaintiff was “unable to work at this 

time,” noting that Plaintiff had headaches on a daily basis for one to three hours with no 

relief and several ancillary symptoms. (Tr. 747.) Dr. Aryal also opined that Plaintiff 

should avoid unprotected heights and moving machinery, that she was moderately limited 

in her ability to participate in activities involving exposure to marked changes in 

temperature and humidity, and exposure to dust, fumes, and gases, and that she was 

mildly limited in her ability to drive automotive equipment. (Tr. 748.) 

 The ALJ assigned this opinion little weight because it was unsupported by, and 

inconsistent with, the medical record. (Tr. 19.) Plaintiff argues that Dr. Aryal’s opinion 

was entitled to controlling weight because she was a treating physician. (Doc. 19 at 21.) 

Although Dr. Aryal was a treating physician, her opinion is not entitled to controlling 

weight because the limitations she identified could not reasonably be expected to result 

from objective findings documented in the medical record. (Tr. 748.) See 20 C.F.R. 

§ 1527(c)(2) and SSR 96-2p, 1996 WL 374188, at *2 (explaining that a medical opinion 

from a treating source is entitled to controlling weight when the opinion is a medical 

opinion, the opinion is well-supported by medically acceptable clinical and laboratory 

diagnostic techniques, and the opinion is “‘not inconsistent’ with the other ‘substantial 

evidence’ in the individual’s case record.).” 

 Additionally, the ALJ gave clear and convincing reasons for assigning little weight 

to Dr. Aryal’s opinion. See Lester, 81 F.3d at 830. The ALJ properly discounted 

Dr. Aryal’s opinion as inconsistent with the medical record and Dr. Aryal’s treatment 

notes. (Tr. 18-19.) See Batson, 359 F.3d at 1195 (an ALJ may discredit treating 

physicians’ opinions that are unsupported by the record as a whole or by objective 

medical findings). The ALJ cited Dr. Aryal’s treatment notes documenting her findings 

that Plaintiff had full strength, and that she could walk on her heels and toes, and tandem 

walk. (Tr. 19 (citing Admin. Hrg. Exs. 20F at 11-12 and 20F at 2).) Additionally, 

Dr. Aryal’s treatment notes reflect significant and ongoing improvement in Plaintiff’s 

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reported headaches over the several years Dr. Aryal treated her. (Tr. 421-26, 510-11, 

676-80.) Dr. Aryal noted similar improvement in Plaintiff’s hand symptoms. (Tr. 425-

26, 564-65, 510-11.) 

 Plaintiff characterizes this evidence as “limited” reports of “some” improvement. 

(Doc. 19 at 22.) However, Dr. Aryal’s treatment notes reflect significant improvement 

over a long period of time. (Tr. 421-26, 510-11, 564-65, 676-80.) Additionally, in 

March 2012, Dr. Aryal opined that Plaintiff was having daily headaches with shortness of 

breath, vertigo/dizziness, fatigue and pain (Tr. 747), however, the majority of Dr. Aryal’s 

treatment notes, including a treatment note from an appointment around the same period 

as her March opinion (Tr. 673-74 (January 17, 2012 treatment note), do not mention 

these symptoms. (Tr. 421-22, 423-23, 425-26, 501, 563-65, 673-74, 676-77, 679.) Thus, 

the ALJ rationally concluded that Dr. Aryal’s opinion was inconsistent with her treatment 

notes. (Tr. 19.) Inconsistency with the record is a proper reason for discounting a 

treating physician’s opinion. See Bayliss, 427 F.3d at 1216 (a doctor’s statement may be 

rejected when her own notes, recorded observations, or recorded opinions contradict the 

statement). 

 As the ALJ noted (Tr. 19), Dr. Aryal also stated that her opinion was based on 

Plaintiff’s self-reporting of her headaches and that the limitations Dr. Aryal described 

could not reasonably be expected to result from objective findings documented in the 

medical record. (Tr. 748.) Considering Dr. Aryal’s own statements about her opinion, it 

was reasonable for the ALJ to assign it little weight. See Batson, 359 F.3d at 1195 (ALJ 

gave specific and legitimate reason for giving treating physician opinion minimal weight 

by noting, in part, opinion did not include supporting objective evidence); Turner v. 

Comm’r of Soc. Sec., 613 F.3d 1217, 1223 (9th Cir. 2010) (fact that opinion was based 

almost entirely on Plaintiff’s self-reporting was a specific and legitimate reason to reject 

the opinion). 

 Finally, even if the ALJ erred in assigning little weight to Dr. Ayral’s opinion, any 

error was harmless for two reasons. First, Dr. Aryal opined that Plaintiff was unable to 

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work, but whether a claimant is able to work is an issue reserved to the Commissioner. 

See 20 C.F.R. § 416.927(d) (stating that the issue of whether a claimant is disabled is 

reserved to the Commissioner and that “[a] statement by a medical source that [a 

claimant] is ‘disabled’ or ‘unable to work’ does not mean that the [Social Security 

Administration] will determine that [a claimant is] disabled.”). A treating source’s 

“opinions on issues reserved to the Commissioner are never entitled to controlling weight 

or special significance.” SSR 96-5p, 1996 WL 374183, at *1. 

 Second, the RFC that the ALJ adopted accounted for Dr. Ayral’s opinions that 

Plaintiff should avoid unprotected heights and moving machinery, that she was 

moderately limited in her ability to participate in activities involving exposure to marked 

changes in temperature and humidity and exposure to dust, fumes, and gases, and that she 

was mildly limited in her ability to drive automotive equipment. (Compare Tr. 748 with

Tr. 17 (concluding that Plaintiff should “avoid exposure to fumes, temperature extremes, 

vibration, and extreme dampness and humidity” and should “not be exposed to dangerous 

machinery and unprotected heights.”).) 

 Therefore, the ALJ did not err in assigning little weight to Dr. Aryal’s opinion and 

substantial evidence supports her assessment of Dr. Aryal’s opinion. Additionally, even 

if the ALJ erred, any error was harmless. Harmless errors in the ALJ’s decision do not 

warrant reversal. Stout v. Comm’r, Soc. Sec. Admin., 454 F.3d 1050, 1055-56 (9th Cir. 

2006). 

B. Assessing a Claimant’s Credibility 

 Plaintiff also asserts that the ALJ erred by discrediting her symptom testimony. 

(Doc. 19 at 8.) An ALJ engages in a two-step analysis to determine whether a claimant’s 

testimony regarding subjective pain or symptoms is credible. Garrison v. Colvin, 759 

F.3d 995, 1014-15 (9th Cir. Jul. 14, 2014) (citing Lingenfelter v. Astrue, 504 F.3d 1028, 

1035-36 (9th Cir. 2007)). 

 “First, the ALJ must determine whether the claimant has presented objective 

medical evidence of an underlying impairment ‘which could reasonably be expected to 

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produce the pain or other symptoms alleged.’” Lingenfelter, 504 F.3d at 1036 (quoting 

Bunnell v. Sullivan, 947 F.2d 341, 344 (9th Cir. 1991) (en banc)). The claimant is not 

required to show objective medical evidence of the pain itself or of a causal relationship 

between the impairment and the symptom. Smolen, 80 F.3d at 1282. Instead, the 

claimant must only show that an objectively verifiable impairment “could reasonably be 

expected” to produce his pain. Lingenfelter, 504 F.3d at 1036 (quoting Smolen, 80 F.3d 

at 1282); see also Carmickle v. Comm’r of Soc. Sec., 533 F.3d at 1160B61 (9th Cir. 2008) 

(“requiring that the medical impairment ‘could reasonably be expected to produce’ pain 

or another symptom . . . requires only that the causal relationship be a reasonable 

inference, not a medically proven phenomenon”). 

 Second, if a claimant shows that she suffers from an underlying medical 

impairment that could reasonably be expected to produce her pain or other symptoms, the 

ALJ must “evaluate the intensity and persistence of [the] symptoms” to determine how 

the symptoms, including pain, limit the claimant’s ability to work. See 20 

C.F.R. § 404.1529(c)(1). In making this evaluation, the ALJ may consider the objective 

medical evidence, the claimant’s daily activities, the location, duration, frequency, and 

intensity of the claimant’s pain or other symptoms, precipitating and aggravating factors, 

medication taken, and treatments for relief of pain or other symptoms. See 20 

C.F.R. § 404.1529(c); Bunnell, 947 F.2d at 346. 

 At this second evaluative step, the ALJ may reject a claimant’s testimony 

regarding the severity of her symptoms only if the ALJ “makes a finding of malingering 

based on affirmative evidence,” Lingenfelter, 504 F.3d at 1036 (quoting Robbins v. Soc. 

Sec. Admin., 466 F.3d 880, 883 (9th Cir. 2006)), or if the ALJ offers “clear and 

convincing reasons” for finding the claimant not credible.4

 Carmickle, 533 F.3d at 1160 

(quoting Lingenfelter, 504 F.3d at 1036). “‘The clear and convincing standard is the 

most demanding required in Social Security Cases.’” Garrison, 759 F.3d at 1015 

 

4

 The Ninth Circuit has rejected the Commissioner’s argument (Doc. 20 at 22 n.4; Doc. 24) that a lesser standard than “clear and convincing” should apply. Garrison, 759 

F.3d at 1015 n.18. 

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(quoting Moore v. Soc. Sec. Admin., 278 F.3d 920, 924 (9th Cir. 2002)). Because there 

was no record evidence of malingering, the ALJ was required to provide clear and 

convincing reasons for concluding that Plaintiff’s subjective complaints were not wholly 

credible. Plaintiff argues that the ALJ failed to do so. 

 1. Plaintiff’s Daily Activities 

 The ALJ discounted Plaintiff’s symptom testimony because her daily activities, 

which included childcare, were not as limited as would be expected considering 

Plaintiff’s complaints of disabling symptoms. (Tr. 20.) Plaintiff asserts that this was not 

a clear and convincing reason for discrediting her symptom testimony. (Doc. 19 at 9.) 

 The Ninth Circuit has stated that a claimant’s participation in normal daily 

activities “does not in any way detract from [her] credibility as to [her] overall 

disability.” Vertigan v. Halter, 260 F.3d 1044, 1050 (9th Cir. 2001). As the Ninth 

Circuit has explained, “[o]ne does not need to be ‘utterly incapacitated’ in order to be 

disabled.” Id. (quoting Fair v. Bowen, 885 F.2d 597, 603 (9th Cir. 1989)). Rather, the 

daily activities must involve skills that could be transferrable to a workplace and a 

claimant must spend a “substantial part of [her] day” engaged in those activities. See Orn 

v. Astrue, 495 F.3d 625, 639 (9th Cir. 2007) (finding that the ALJ erred in failing to 

“meet the threshold for transferable work skills, the second ground for using daily 

activities in credibility determinations.”). 

 The Ninth Circuit has found that the ability to care for a child may be evidence of 

a claimant’s ability to work. See Molina v. Astrue, 674 F.3d 1104, 1113 (9th Cir. 2012) 

(“The ALJ could reasonably conclude that Molina’s activities, including walking her two 

grandchildren to and from school, attending church, shopping, and taking walks, 

undermined her claims that she was incapable of being around people without suffering 

debilitating panic attacks.”); Rollins v. Massanari, 261 F.3d 853, 857 (9th Cir. 2001) (the 

ALJ properly found that the claimant’s claim of totally disabling pain was undermined by 

her testimony about her activities, such as attending to the needs of her two young 

children. 

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 In discrediting Plaintiff’s symptom testimony, the ALJ noted that Plaintiff dusted, 

grocery shopped, and drove. (Tr. 20.) She also noted that Plaintiff helped care for her 

grandchild (made him breakfast, dinner, and picked him up from school). (Id.) 

Plaintiff’s ability to regularly care for her grandchild is a legally sufficient reason for 

rejecting Plaintiff’s symptom testimony. See Orn, 495 F.3d at 639 (daily activities, 

including child care, may be grounds for an adverse credibility”); Rollins, 261 F.3d at 

857 (allegations of disability were undermined by activities such as tending to the needs 

of two young children, cooking, housekeeping, doing laundry, shopping, and attending 

therapy and various other meetings). 

 2. Effectiveness of Treatment 

 The ALJ also cited to Plaintiff’s reported improvement to support her 

determination that Plaintiff’s symptom testimony was not fully credible. (Tr. 20.) In 

assessing a claimant’s credibility, the ALJ may consider “the type, dosage, effectiveness, 

and side effects of any medication” and treatment, other than medication, that the 

claimant has received for relief of pain or other symptoms. 20 C.F.R. 

§ 404.1529(c)(3)(iv) and (v). Evidence that treatment can effectively control a claimant’s 

symptoms may be a clear and convincing reason to find a claimant less credible. See

Warre v. Comm’r, of Soc. Sec. Admin., 439 F.3d 1001, 1006 (9th Cir. 2006) (stating that 

“[i]mpairments that can be controlled effectively with medication are not disabling for 

purposes of determining eligibility for SSI benefits.”) The record reflects significant and 

ongoing improvement in Plaintiff’s reported headaches over several years. (Tr. 421-26, 

510-11, 676-80.) Additionally, Plaintiff denied having daily headaches. (Tr. 421.) The 

ALJ did not err in rejecting Plaintiff’s symptom testimony based on evidence that her 

headaches responded to treatment. 

 Plaintiff argues that her reports of improvement only applied to her headaches, and 

therefore, the effectiveness of treatment did not support the ALJ’s rejection of her 

subjective complaints of pain and fatigue. (Doc. 19 at 24.) The Court disagrees. During 

the administrative hearing, Plaintiff testified to having daily, worsening headaches lasting 

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an hour or more. (Tr. 55-56, 58.) However, the record evidence shows that Plaintiff 

reported significant and longstanding improvement in her headaches (and a frequency of 

only one per month) to Dr. Aryal. This record evidence is inconsistent with Plaintiff’s 

hearing testimony and this inconsistency is a significant fact in evaluating her overall 

credibility, not just her credibility as related to her headaches. See SSR 96-7p, 1996 WL 

374186, at *5 (“one strong indication of the credibility of an individual’s statements is 

their consistency, both internally and with other information in the case record.”). 

 3. Plaintiff’s Demeanor 

 The ALJ also found Plaintiff’s “demeanor while testifying at the [administrative] 

hearing was generally unpersuasive.” (Tr. 21.) Plaintiff asserts that the ALJ’s finding 

that her demeanor was generally unpersuasive is an invalid reason for discounting her 

credibility. (Doc. 19 at 25.) Plaintiff contends that her pain and fatigue from her 

chemotherapy should have been “readily apparent.” (Id.) Although an ALJ’s personal 

observations, standing alone, cannot support a determination that a claimant is not 

credible, they may form part of that determination. Fair, 885 F.2d at 602; see also 

Morgan v. Comm’r of Soc. Sec. Admin., 169 F.3d 595, 600 (9th Cir. 1999) (“The 

inclusion of the ALJ’s personal observations does not render the decision improper.”) 

(internal quotation omitted); SSR 96-7p, 1996 WL 374186, at *5 (stating that when “the 

individual attends an administrative proceeding conducted by the adjudicator, the 

adjudicator may also consider his or her own recorded observations of the individual as 

part of the overall evaluation of the credibility of the individual's statements.”) 

Accordingly, the ALJ did not err by discounting Plaintiff’s credibility, in part, based on 

her demeanor during the administrative hearing. 

VII. Conclusion

As set forth above, the ALJ’s opinion is supported by substantial evidence in the 

record and is free of harmful legal error. 

 Accordingly, 

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IT IS ORDERED that the Commissioner’s disability determination is 

AFFIRMED. The Clerk of Court is directed to enter judgment in favor of the 

Commissioner and against Plaintiff and to terminate this action. 

 Dated this 12th day of February, 2015. 

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