Source: s3://data.kl3m.ai/documents/govinfo/USCOURTS/USCOURTS-caed-1_18-cv-01320/USCOURTS-caed-1_18-cv-01320-8/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

EASTERN DISTRICT OF CALIFORNIA

DAVID TUUPOINA,

Plaintiff,

v.

ANDREW SAUL, Commissioner of Social 

Security,

Defendant.

No. 1:18-cv-01320-GSA

ORDER DIRECTING ENTRY OF 

JUDGMENT IN FAVOR OF 

COMMISSIONER OF SOCIAL SECURITY

AND AGAINST PLAINTIFF

I. Introduction

Plaintiff David Tuupoina (“Plaintiff”) seeks judicial review of the final decision of the 

Commissioner of Social Security (“Commissioner” or “Defendant”) denying his application for 

disability insurance benefits pursuant to Title II and supplemental security income pursuant to 

Title XVI of the Social Security Act. The matter is currently before the Court on the parties’ 

briefs which were submitted without oral argument to the Honorable Gary S. Austin, United 

States Magistrate Judge.1 See Docs. 19 and 26. Having reviewed the record as a whole, the 

Court finds that the ALJ’s decision is supported by substantial evidence and applicable law. 

Accordingly, Plaintiff’s appeal is denied.

 

1 The parties consented to the jurisdiction of the United States Magistrate Judge. See Docs.8 and 10.

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II. Procedural Background

On December 22, 2009, Plaintiff filed applications for disability insurance benefits and 

supplemental security income alleging disability beginning October 1, 2009. AR 126. Following 

initial review, reconsideration and an agency hearing, the Commissioner denied the applications 

on October 11, 2012. AR 126. The Appeals Council denied review on November 21, 2013. AR 

126. 

On January 27, 2014, Plaintiff again filed applications for disability insurance benefits2

and supplemental security income alleging disability beginning October 1, 2009. AR 33. The 

Commissioner denied the application initially on July 15, 2014, and following reconsideration on 

November 19, 2014. AR 33. 

On December 22, 2014, Plaintiff filed a request for a hearing. AR 33. Administrative 

Law Judge Nancy Stewart presided over an administrative hearing on September 26, 2016. AR 

86-105. Plaintiff appeared and was represented by an attorney. AR 86. On December 8, 2016, 

the ALJ denied Plaintiff’s application. AR 33-40.

The Appeals Council denied review on February 13, 2018. AR 7-13. On September 25, 

2018, 2018, Plaintiff filed a complaint in this Court. Doc. 1. 

III. Factual Background

A. Plaintiff’s Testimony

Plaintiff (born May 18, 1964) completed the twelfth grade. AR 90. He had previously 

worked as a security bouncer at a nightclub, where he was paid “under the table.” AR 92-93. 

During the day, Plaintiff was responsible for accepting liquor deliveries and moving stage and 

dance floor equipment according to the night’s planned entertainment. AR 94-95. 

Plaintiff was using marijuana to relieve his pain even though his doctor had declined to 

give Plaintiff a medical marijuana card. AR 96-97. He was able to lift fifty pounds comfortably, 

much less than he had to lift on his last job. AR 97. In the mornings he walked his daughters one 

mile to school, then rested outside the office before walking home. AR 98. When he experienced 

pain while standing, as when he did the dishes, Plaintiff took a break. AR 98. He was most 

 

2 December 31, 2014, was the last date of Plaintiff’s eligibility for disability insurance coverage. AR 35.

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comfortable sitting or lying on the floor. AR 99. When his pain was severe, Plaintiff smoked 

marijuana and lay down. AR 100.

B. Medical Records

The administrative record includes limited medical records. At the administrative hearing

Plaintiff’s attorney confirmed that the record was complete and that Plaintiff had not seen his 

primary care physician “in quite some time.” AR 89.

On December 28, 2013, Plaintiff was treated in the emergency department of Memorial 

Hospital Los Banos (MHLB) for an itchy rash diagnosed as ringworm. AR 365. Emergency 

room personnel also prescribed blood pressure medication because Plaintiff’s blood pressure was 

high (199/110). AR 365-68. Plaintiff returned to MHLB on January 31, 2014, with a pruritic 

erythematous rash. AR 372-78.

On June 23, 2014, Plaintiff was treated in the emergency department following a fall in 

his bathtub. AR 381-83. Medical personnel diagnosed strain of the abductor muscles of the right 

leg and right paralumbar muscles and prescribed valium and Norco. AR 382-83. On June 25, 

2014, Anna Vaz, NP, treated Plaintiff for muscle spasm at Santa Clara Valley Medical Center. 

AR 392. Ms. Vaz prescribed Flexeril. AR 392. 

In the emergency department of Emanuel Medical Center on February 14, 2016, Brad 

Ramsey, D.O., treated Plaintiff for acute lumbar radiculopathy. AR 401. Dr. Ramsey prescribed 

Baclofen and Naproxen and directed Plaintiff to follow up with his primary care physician. AR 

401.

On February 26, 2015, Plaintiff was treated for rectal bleeding in the gastroenterology 

department of Santa Clara Valley Medical Center. AR 403-08. In the course of a colonoscopy on 

June 3, 2015, Nimeesh Shah, M.D., removed three polyps from Plaintiff’s colon. AR 409-10. In 

July 2015, doctors reported that the polyps were invasive carcinoma but that there was no 

evidence of metastases. AR 414.

In July 2016, Peter Park, M.D., diagnosed a ganglion cyst in Plaintiff’s right wrist and 

prescribed Naproxen. AR 426.

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IV. Standard of Review

Pursuant to 42 U.S.C. §405(g), this court has the authority to review a decision by the 

Commissioner denying a claimant disability benefits. “This court may set aside the 

Commissioner’s denial of disability insurance benefits when the ALJ’s findings are based on 

legal error or are not supported by substantial evidence in the record as a whole.” Tackett v. 

Apfel, 180 F.3d 1094, 1097 (9th Cir. 1999) (citations omitted). Substantial evidence is evidence 

within the record that could lead a reasonable mind to accept a conclusion regarding disability 

status. See Richardson v. Perales, 402 U.S. 389, 401 (1971). It is more than a scintilla, but less 

than a preponderance. See Saelee v. Chater, 94 F.3d 520, 522 (9th Cir. 1996) (internal citation 

omitted). When performing this analysis, the court must “consider the entire record as a whole 

and may not affirm simply by isolating a specific quantum of supporting evidence.” Robbins v. 

Social Security Admin., 466 F.3d 880, 882 (9th Cir. 2006) (citations and internal quotation marks 

omitted).

If the evidence reasonably could support two conclusions, the court “may not substitute its 

judgment for that of the Commissioner” and must affirm the decision. Jamerson v. Chater, 112 

F.3d 1064, 1066 (9th Cir. 1997) (citation omitted). “[T]he court will not reverse an ALJ’s 

decision for harmless error, which exists when it is clear from the record that the ALJ’s error was 

inconsequential to the ultimate nondisability determination.” Tommasetti v. Astrue, 533 F.3d 

1035, 1038 (9th Cir. 2008) (citations and internal quotation marks omitted).

V. The Disability Standard

To qualify for benefits under the Social Security Act, a plaintiff must 

establish that he or she is unable to engage in substantial gainful 

activity due to a medically determinable physical or mental 

impairment that has lasted or can be expected to last for a continuous

period of not less than twelve months. 42 U.S.C. § 1382c(a)(3)(A). 

An individual shall be considered to have a disability only if . . . his 

physical or mental impairment or impairments are of such severity 

that he is not only unable to do his previous work, but cannot, 

considering his age, education, and work experience, engage in any 

other kind of substantial gainful work which exists in the national 

economy, regardless of whether such work exists in the immediate 

area in which he lives, or whether a specific job vacancy exists for 

him, or whether he would be hired if he applied for work.

42 U.S.C. §1382c(a)(3)(B).

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To achieve uniformity in the decision-making process, the Commissioner has established 

a sequential five-step process for evaluating a claimant’s alleged disability. 20 C.F.R. §§ 

416.920(a)-(f). The ALJ proceeds through the steps and stops upon reaching a dispositive finding 

that the claimant is or is not disabled. 20 C.F.R. §§ 416.927, 416.929.

Specifically, the ALJ is required to determine: (1) whether a claimant engaged in 

substantial gainful activity during the period of alleged disability, (2) whether the claimant had 

medically determinable “severe impairments,” (3) whether these impairments meet or are 

medically equivalent to one of the listed impairments set forth in 20 C.F.R. § 404, Subpart P, 

Appendix 1, (4) whether the claimant retained the residual functional capacity (“RFC”) to 

perform his past relevant work, and (5) whether the claimant had the ability to perform other jobs 

existing in significant numbers at the national and regional level. 20 C.F.R. § 416.920(a)-(f).

In addition, when an applicant has one or more previous denials of applications for 

disability benefits, as Plaintiff does in this case, he or she must overcome a presumption of 

nondisability. The principles of res judicata apply to administrative decisions, although the 

doctrine is less rigidly applied to administrative proceedings than in court. Chavez v. Bowen, 844 

F.2d 691, 693 (9th Cir. 1988); Gregory v. Bowen, 844 F.2d 664, 666 (9th Cir. 1988). 

Social Security Acquiescence Ruling (“SSR”) 97–4(9), adopting Chavez, applies to cases 

involving a subsequent disability claim with an unadjudicated period arising under the same title 

of the Social Security Act as a prior claim in which there has been a final administrative decision 

that the claimant is not disabled. A previous final determination of nondisability creates a 

presumption of continuing nondisability in the unadjudicated period. Lester v. Chater, 81 F.3d 

821, 827 (9th Cir. 1995). The presumption may be overcome by a showing of changed 

circumstances, such as new and material changes to the claimant's RFC, age, education, or work 

experience. Id. at 827–28; Chavez, 844 F.2d at 693.

VI. Summary of the ALJ’s Decision

Acknowledging Plaintiff’s previous applications for disability insurance benefits and

supplemental security income, the ALJ found that the circumstances had changed since Plaintiff’s 

prior application. AR 33. Accordingly, she concluded that the presumption of continuing 

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disability did not apply to the 2014 application, but that the October 11, 2012 decision was res 

judicata through that date. AR 33.

The Administrative Law Judge found that Plaintiff had not engaged in substantial gainful 

activity since the alleged onset date of October 1, 2009. AR 35. His severe impairments 

included: disorder of the spine with radiculopathy; disorder of the right knee; and obesity. AR 

36. None of the severe impairments met or medically equaled one of the listed impairments in 20 

C.F.R. Part 404, Subpart P, Appendix 1 (20 C.F.R. §§ 404.1520(d), 404.1525, 404.1526, 

416.920(d), 416.925 and 416.926). AR 36. 

The ALJ concluded that Plaintiff had the residual functional capacity to perform light

work as defined in 20 C.F.R. §§ 404.1567(b) and 416.967(b), except that he could lift, carry push 

and pull 25 pounds occasionally and 10 pounds frequently, and could stand and walk six hours in 

an eight-hour workday with the ability to rest at the end of each hour for about one minute. AR 

36. He needed to rest for fifteen minutes every two hours falling within normal breaks and lunch 

period. AR 36. Plaintiff could sit without limitation. AR 36. Plaintiff was unable to climb 

ladders, ropes or scaffolds. AR 36. He could perform all other postural activities occasionally. 

AR 36.

Plaintiff was unable to perform his past relevant work. AR 39. However, considering 

Plaintiff’s age, education, work experience and residual functional capacity jobs that he could 

perform existed in significant numbers in the national economy. AR 39. Accordingly, the ALJ 

found that Plaintiff was not disabled at any time from October 1, 2009, the alleged onset date, 

through December 8, 2016, the date of the decision. AR 40.

VII. Reliability of Plaintiff’s Testimony

Plaintiff contends that the ALJ failed to provide clear and convincing reasons for 

concluding that Plaintiff’s allegations of his knee and back pain were not fully credible. The 

Commissioner contends that because of Plaintiff’s lack of treatment and minimal objective 

findings, the ALJ properly determined that Plaintiff’s subjective testimony was not supported by 

the objective medical evidence.

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An ALJ is responsible for determining credibility, resolving conflicts in medical 

testimony and resolving ambiguities. Andrews v. Shalala, 53 F.3d 1035, 1039 (9th Cir. 1995). 

His or her findings of fact must be supported by “clear and convincing evidence.” Burrell v. 

Colvin, 775 F.3d 1133, 1136-37 (9th Cir. 2014).

To determine whether the ALJ’s findings are supported by sufficient evidence a court 

must consider the record as a whole, weighing both the evidence that supports the ALJ’s 

determination and the evidence against it. Magallanes v. Bowen, 881 F.2d 747, 750 (9th Cir. 

1989). “[A] federal court’s review of Social Security determinations is quite limited.” BrownHunter v. Colvin, 806 F.3d 487, 492 (9th Cir. 2015). “For highly fact-intensive individualized 

determinations like a claimant’s entitlement to disability benefits, Congress places a premium 

upon agency expertise, and, for the sake of uniformity, it is usually better to minimize the 

opportunity for reviewing courts to substitute their discretion for that of the agency.” Id. (quoting 

Treichler v. Comm’r of Soc. Sec. Admin., 775 F.3d 1090, 1098 (9th Cir. 2014), quoting Consolo v. 

Fed. Mar. Comm’n, 383 U.S. 607, 621 (1966)) (internal quotation marks omitted). Federal courts 

should generally “’leave it to the ALJ to determine credibility, resolve conflicts in the testimony, 

and resolve ambiguities in the record.’” Brown-Hunter, 806 F.3d at 492 (quoting Treichler, 775 

F.3d at 1098).

A claimant’s statements of pain or other symptoms are not conclusive evidence of a 

physical or mental impairment or disability. 42 U.S.C. § 423(d)(5)(A); Soc. Sec. Rul. 16-3p. 

“An ALJ cannot be required to believe every allegation of [disability], or else disability benefits 

would be available for the asking, a result plainly contrary to the [Social Security Act].” Fair v. 

Bowen, 885 F.2d 597, 603 (9th Cir. 1989). 

Social Security Ruling 16-3p applies to disability applications heard by the agency on or 

after March 28, 2016. Ruling 16-3p eliminated the use of the term “credibility” to emphasize that 

subjective symptom evaluation is not “an examination of an individual’s character” but an 

endeavor to “determine how symptoms limit ability to perform work-related activities.” S.S.R. 

16-3p at 1-2.

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An ALJ performs a two-step analysis to determine whether a claimant’s testimony 

regarding subjective pain or symptoms is credible. See Garrison v. Colvin, 759 F.3d 995, 1014 

(9th Cir. 2014); Smolen v. Chater, 80 F.3d 1273, 1281 (9th Cir. 1996); S.S.R 16-3p at 3. First, the 

claimant must produce objective medical evidence of an impairment that could reasonably be 

expected to produce some degree of the symptom or pain alleged. Garrison, 759 F.3d at 1014; 

Smolen, 80 F.3d at 1281-1282. In this case, the first step is satisfied by the ALJ’s finding that 

Plaintiff’s “medically determinable impairments could reasonably be expected to produce the 

alleged symptoms.” AR 37. The ALJ did not find Plaintiff to be malingering.

If the claimant satisfies the first step and there is no evidence of malingering, the ALJ 

must “evaluate the intensity and persistence of [the claimant’s] symptoms to determine the extent 

to which the symptoms limit an individual’s ability to perform work-related activities.” S.S.R. 

16-3p at 2. “[S]ome individuals may experience symptoms differently and may be limited by 

symptoms to a greater or lesser extent than other individuals with the same medical impairments, 

the same objective medical evidence and the same non-medical evidence.” S.S.R. 16-3p at 5. In 

reaching a conclusion, the ALJ must examine the record as a whole, including objective medical 

evidence; the claimant’s representations of the intensity, persistence and limiting effects of his

symptoms; statements and other information from medical providers and other third parties; and, 

any other relevant evidence included in the individual’s administrative record. S.S.R. 16-3p at 5. 

“The determination or decision must contain specific reasons for the weight given to the 

individual’s symptoms, be consistent with and supported by the evidence, and be clearly 

articulated so the individual and any subsequent reviewer can assess how the adjudicator 

evaluated the individual’s symptoms.” SSR 16-3p at *10. 

Because a “claimant’s subjective statements may tell of greater limitations than can 

medical evidence alone,” an “ALJ may not reject the claimant’s statements regarding her 

limitations merely because they are not supported by objective evidence.” Tonapetyan v. Halter, 

242 F.3d 1144, 1147-48 (2001) (quoting Fair, 885 F.2d at 602). See also Bunnell v. Sullivan, 947 

F.2d 341, 345 (9th Cir. 1991) (holding that when there is evidence of an underlying medical 

impairment, the ALJ may not discredit the claimant’s testimony regarding the severity of his 

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symptoms solely because they are unsupported by medical evidence). “Congress clearly meant 

that so long as the pain is associated with a clinically demonstrated impairment, credible pain 

testimony should contribute to a determination of disability.” Id. (internal quotation marks and 

citations omitted).

However, the law does not require an ALJ simply to ignore inconsistencies between 

objective medical evidence and a claimant’s testimony. “While subjective pain testimony cannot 

be rejected on the sole ground that it is not fully corroborated by objective medical evidence, the 

medical evidence is still a relevant factor in determining the severity of claimant’s pain and its 

disabling effects.” Rollins v. Massanari, 261 F.3d 853, 857 (9th Cir. 2001); SSR 16-3p (citing 20 

C.F.R. § 404.1529(c)(2)). As part of his or her analysis of the record as a whole, an ALJ properly 

considers whether the objective medical evidence supports or is consistent with a claimant’s pain 

testimony. Id.; 20 C.F.R. §§ 404.1529(c)(4), 416.1529(c)(4) (symptoms are determined to 

diminish residual functional capacity only to the extent that the alleged functional limitations and 

restrictions “can reasonably be accepted as consistent with the objective medical evidence and 

other evidence”). The ALJ did so here, finding that Plaintiff’s “statements concerning the 

intensity, persistence and limiting effects of these symptoms are not entirely consistent with 

medical evidence and other evidence in the record for the reasons explained in this decision.” AR 

37. 

“[O]bjective medical evidence is a useful indicator to help make reasonable conclusions 

about the intensity and persistence of symptoms, including the effects those symptoms may have 

on the ability to perform work-related activities.” S.S.R. 16-3p at 6. Because objective medical 

evidence may reveal the intensity, persistence and limiting effects of a claimant’s symptoms, an 

ALJ must consider whether the symptoms reported by a claimant are consistent with medical 

signs and laboratory findings of record. Id. 

To explain her assessment of Plaintiff’s lack of reliability in this case, the ALJ stated, 

“The claimant has had very little treatment for his impairments and the objective findings are 

minimal.” AR 37. The ALJ reviewed Plaintiff’s treatment for back pain in June 2014 and 

///

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February 2015, Dr. Bayne’s consultative examination and the opinions of the agency physicians. 

AR 37-38

In assessing a claimant’s credibility, an ALJ may properly rely on “unexplained or 

inadequately explained failure to seek treatment or follow a prescribed course of treatment.” 

Molina v. Astrue, 674 F.3d 1104, 1113 (9th Cir. 2012). A claimant’s failure to assert a good 

reason for not seeking treatment or for failing to follow a prescribed course of treatment or an 

ALJ’s finding that the proffered reason is not credible, cast doubt on the sincerity of the 

claimant’s testimony. Fair, 885 F.2d at 603. “[I]f the frequency or extent of the treatment 

sought by an individual is not comparable with the degree of the individual’s subjective 

complaints, or if the individual fails to follow prescribed treatment that may improve symptoms,

we may find the alleged intensity and persistence of an individual’s symptoms are inconsistent 

with the overall evidence of record.” SSR 16-3p at 9.

Here, Plaintiff contends that because he lacks medical insurance, his subjective testimony 

should not be discounted based on his limited medical treatment. As summarized in the factual 

background statement above, however, Plaintiff sought treatment for acute, alarming or painful 

conditions including itchy or visually disturbing rashes, blood in his stool and a ganglion cyst in 

his right wrist. A claimant’s ability to seek and obtain affordable medical care for other ailments 

supports a reasonable inference that the claimant could have obtained care for the allegedly 

disabling impairment if his symptoms were as severe as he alleged. Karabajakyan v. Berryhill, 

713 Fed.Appx. 553, 555 (9th Cir. 2017).

In contrast to his other ailments, Plaintiff sought treatment of back pain on only two 

occasions, once following a fall in the bathtub. Such limited treatment fails to support his 

contention that he was unable to work because of constant debilitating pain. “That [a plaintiff’s] 

pain was ‘not severe enough to motivate [her] to seek [these forms] of treatment,’ even if she 

sought some treatment, is powerful evidence of the extent to which she was in pain.” Burch v. 

Barnhart, 400 F.3d 676, 681 (9th Cir. 2005) (quoting Fair, 885 F.2d at 604). 

As is always the case in an appeal of the Commissioner’s denial of disability benefits, 

Plaintiff would construe the evidence differently than the ALJ. Nonetheless, the hearing decision 

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sets forth sufficient evidence in the record to support the ALJ’s determination that Plaintiff’s 

representations to the agency were not fully consistent with the medical evidence of record. The 

Court therefore cannot second guess the ALJ’s assessment of Plaintiff’s credibility.

VIII. Sufficient Evidence Supported the ALJ’s Determination

Plaintiff contends that the determination of Plaintiff’s residual functional capacity was not 

supported by sufficient evidence. The Commissioner disagrees. After carefully reviewing the 

administrative record and the ALJ’s analysis, the Court concludes that substantial evidence 

supported the ALJ’s determination of Plaintiff’s residual functional capacity.

A. Medical Opinions

1. Agency Physicians

In the initial evaluation, agency physician K. Quint, M.D. opined that Plaintiff could lift 

twenty pounds occasionally and ten pounds frequently; stand or walk six hours in an eight-hour 

work day; and, sit about six hours in an eight-hour workday. AR 132, 144. Plaintiff could 

occasionally balance, stoop, kneel, crouch and crawl, but could never climb ladders, ropes or 

scaffolds. AR 132, 144. He should avoid concentrated exposure to hazards such as machinery 

and heights. AR 133, 145.

Following the initial evaluation, Plaintiff slipped in the bathtub, injuring right abductor 

and right paralumbar muscles. AR 157, 171. Thereafter, Plaintiff experienced traumatic muscle 

spasms. AR 157. Evaluating Plaintiff’s medical claim on reconsideration, agency physician C. 

De la Rosa, M.D., noted that because Plaintiff’s recent injury was likely to resolve within twelve 

months, it did not impact Plaintiff’s residual functional capacity. AR 157. Dr. De la Rosa agreed 

with Dr. Quint’s assessment of Plaintiff’s residual functional capacity except for the applicable 

environmental restrictions. AR 160-61, 173-75. Dr. De la Rosa opined that Plaintiff should avoid 

concentrated exposure to extreme cold and heat and vibration but exposure to hazards was 

unlimited. AR 160-61.

On reconsideration, agency psychiatrist Mark Dilger, M.D., performed the psychiatric 

review technique and opined that Plaintiff had no psychological disability. AR 158, 172.

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B. Orthopedic Consultative Examination

On June 18, 2014, orthopedist Omar Bayne, M.D., prepared an evaluation of Plaintiff’s 

knee pain and recurrent back pain. AR 359-61. Plaintiff reported a history of lumbar 

degenerative disc disease with possible spondylolisthesis that resulted in radicular pain and 

numbness of the lower left extremity. AR 359. He had received conservative treatment including 

pain and anti-inflammatory medications and chiropractic manipulation. AR 359. Plaintiff could 

partially alleviate his pain by avoiding aggravating factors such as bending, twisting, crouching 

crawling and stooping. AR 359. Plaintiff could lift no more than ten pounds, walk about onehalf block and sit for ten to fifteen minutes. AR 359.

As a young man Plaintiff broke his right knee cap while playing football. AR 359. He 

now experienced knee pain when squatting, kneeling, crouching and stooping and was unable to 

run or play sports. AR 359. 

Plaintiff had difficulty lying on his back and experienced significant sleep disturbance. 

AR 359. His medications included lisinopril; over-the-counter pain relievers such as ibuprofen 

(Advil) and Aleve; and, medical marijuana. AR 359. Because Plaintiff had no medical 

insurance, he did not take prescription pain medications and had significant muscle spasms upon 

palpation. AR 359. 

Examination revealed a slow, bent-over gait and difficulty walking on heels and toes. AR 

359. Plaintiff was only able to squat about fifty per cent of normal due to knee and back pain. 

AR 359. The cervical spine examination was generally normal. AR 360. Plaintiff’s lumbosacral 

spine lacked a normal lordotic curve and was tender to palpation. AR 360. Straight leg raising 

was sixty degrees on the left with radiculopathy, and seventy degrees on the right with low back 

pain and spasms. AR 360. Strength and range of motion in the lower extremities was normal,

however, the right knee was tender to palpation. AR 360. Plaintiff had reduced sensation to light 

touch on the left calf and thigh over the L5 dermatome distribution. AR 360.

Dr. Bayne diagnosed chronic recurrent low back strain/sprain; lumbar degenerative disc 

disease with L5 radiculopathy; history of right patellar fracture; right patellofemoral arthritis; 

history of hypertension; and, history of insomnia. AR 360. The doctor opined:

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[Plaintiff] should be able to stand and walk with appropriate breaks 

for four hours in an eight-hour workday. He should be able to sit 

with appropriate breaks for six hours in an eight-hour workday. 

Repetitive bending, twisting, crouching, crawling, stooping, 

kneeling, climbing up and down stairs, inclines, ramps or ladders 

should be limited to occasionally. He should be able to lift and carry 

20 pounds frequently and 40 pounds occasionally. He should be able 

to work in any work environment except on unprotected heights.

AR 360. 

B. Determining Residual Functional Capacity

“Residual functional capacity is an assessment of an individual’s ability to do sustained 

work-related physical and mental activities in a work setting on a regular and continuing basis.” 

SSR 96-8p. The residual functional capacity assessment considers only functional limitations and 

restrictions which result from an individual’s medically determinable impairment or combination 

of impairments. SSR 96-8p. 

A determination of residual functional capacity is not a medical opinion, but a legal 

decision that is expressly reserved for the Commissioner. See 20 C.F.R. §§ 404.1527(d)(2) (RFC 

is not a medical opinion), 404.1546(c) (identifying the ALJ as responsible for determining RFC). 

“[I]t is the responsibility of the ALJ, not the claimant’s physician, to determine residual 

functional capacity.” Vertigan v. Halter, 260 F.3d 1044, 1049 (9th Cir. 2001). In doing so the 

ALJ must determine credibility, resolve conflicts in medical testimony and resolve evidentiary 

ambiguities. Andrews, 53 F.3d at 1039-40. 

“In determining a claimant's RFC, an ALJ must consider all relevant evidence in the 

record such as medical records, lay evidence and the effects of symptoms, including pain, that are 

reasonably attributed to a medically determinable impairment.” Robbins, 466 F.3d at 883. See 

also 20 C.F.R. § 404.1545(a)(3) (residual functional capacity determined based on all relevant 

medical and other evidence). “The ALJ can meet this burden by setting out a detailed and 

thorough summary of the facts and conflicting evidence, stating his interpretation thereof, and 

making findings.” Magallanes, 881 F.2d at 751 (quoting Cotton v. Bowen, 799 F.2d 1403, 1408 

(9th Cir. 1986)). 

///

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The opinions of treating physicians, examining physicians, and non-examining physicians 

are entitled to varying weight in residual functional capacity determinations. Lester, 81 F.3d at

830. Ordinarily, more weight is given to the opinion of a treating professional, who has a greater 

opportunity to know and observe the patient as an individual. Id.; Smolen v. Chater, 80 F.3d 

1273, 1285 (9th Cir. 1996). The opinion of an examining physician is, in turn, entitled to greater 

weight than the opinion of a non-examining physician. Pitzer v. Sullivan, 908 F.2d 502, 506 (9th 

Cir. 1990). An ALJ may reject an uncontradicted opinion of a treating or examining medical 

professional only for “clear and convincing” reasons. Lester, 81 F.3d at 831. In contrast, a 

contradicted opinion of a treating professional may be rejected for “specific and legitimate” 

reasons. Id. at 830. However, the opinions of a treating or examining physician are “not 

necessarily conclusive as to either the physical condition or the ultimate issue of disability.” 

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

C. The ALJ Properly Analyzed Evidence in the Record as a Whole

“[A]n ALJ is responsible for determining credibility and resolving conflicts in medical 

testimony.” Magallanes, 881 F.2d at 750. An ALJ may choose to give more weight to opinions 

that are more consistent with the evidence in the record. 20 C.F.R. §§ 404.1527(c)(4) (“the more 

consistent an opinion is with the record as a whole, the more weight we will give to that 

opinion”). 

The ALJ gave little weight to Dr. Bayne’s opinion that Plaintiff could stand and walk for 

only four hours in an eight-hour work day, but adopted the doctor’s restrictions on Plaintiff’s 

climbing ladders, ropes, scaffolds and limits on other postural activities. AR 38. She noted that 

Plaintiff testified that he was able to lift fifty pounds and that Dr. Bayne opined that Plaintiff 

could lift and carry 20 pounds frequently and 40 pounds occasionally. AR 38. Despite Plaintiff’s 

admission of greater weight-bearing ability, the ALJ gave some weight to Dr. Bayne’s opinion, 

but reduced the amount of weight in Plaintiff’s residual functional capacity to assist in Plaintiff’s 

ability to stand and walk for longer periods without rest. AR 38. The ALJ also gave some weight 

to the opinions of Drs. Quint and De la Rosa but found that the record as a whole did not support 

the conflicting environmental restrictions imposed by the agency physicians. AR 38

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“[A]n ALJ is responsible for determining credibility and resolving conflicts in medical 

testimony.” Magallanes, 881 F.2d at 750. He properly determines the weight to be given each 

medical opinion by considering the evidence in the record as the ALJ did here. 20 C.F.R. § 

404.1527(c)(4) (“the more consistent an opinion is with the record as a whole, the more weight

we will give to that opinion”). The record must include objective evidence to support the medical 

opinion of the claimant’s residual functional capacity. Meanel v. Apfel, 172 F.3d 1111, 1113-14

(9th Cir. 1999). Inconsistencies with the overall record or with a physician’s own notes are a valid 

basis to reject a medical opinion. Molina v. Astrue, 674 F.3d 1104, 1111-1112 (9th Cir. 2012) 

(recognizing that a conflict with treatment notes is a germane reason to reject a treating 

physician's assistant's opinion); Connett v. Barnhart, 340 F.3d 871, 875 (9th Cir. 2003) (rejecting

physician’s opinion when treatment notes provide no basis for the opined functional restrictions);

Tommasetti, 533 F.3d at 1041 (incongruity between questionnaire responses and the Plaintiff’s 

medical records is a specific and legitimate reason for rejecting an opinion); Valentine v. Comm'r 

of Soc. Sec. Admin., 574 F.3d 685, 692-693 (9th Cir. 2009) (holding that a conflict with treatment 

notes is a specific and legitimate reason to reject a treating physician's opinion). 

Plaintiff contends that in evaluating Dr. Bayne’s opinion, the ALJ impermissibly conflated 

Plaintiff’s residual ability to stand and walk with his ability to bear weight. Although focusing 

solely on the ALJ’s evaluation of Dr. Bayne’s opinion could lead to such a conclusion, the record 

as a whole establishes the contrary. The ALJ also gave some weight to the opinions of the agency 

physicians who opined that Plaintiff could walk for longer periods but lift less weight, rejecting 

only the conflicting environmental restrictions to which the agency physicians opined. The 

agency physicians’ opinions supported the ALJ’s conclusions concerning Plaintiff’s residual 

functional capacity to lift weight and to stand and walk in an eight-hour work day. Thus, the 

ALJ’s determination was appropriately supported by the record as a whole.

X. Conclusion and Order

Based on the foregoing, the Court finds that the ALJ’s decision that Plaintiff is not 

disabled is supported by substantial evidence in the record as a whole and is based on proper legal

standards. Accordingly, this Court DENIES Plaintiff’s appeal from the administrative decision of 

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the Commissioner of Social Security. The Clerk of Court is directed to enter judgment in favor of 

Defendant Andrew Saul, Commissioner of Social Security, and against Plaintiff David Tuupoina.

IT IS SO ORDERED.

Dated: January 6, 2020 /s/ Gary S. Austin 

 UNITED STATES MAGISTRATE JUDGE

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