Source: s3://data.kl3m.ai/documents/govinfo/USCOURTS/USCOURTS-azd-3_19-cv-08113/USCOURTS-azd-3_19-cv-08113-0/pdf.json

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

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WO

IN THE UNITED STATES DISTRICT COURT

FOR THE DISTRICT OF ARIZONA

Timothy Earl O'Neil,

Plaintiff,

v. 

Commissioner of Social Security 

Administration,

Defendant.

No. CV-19-08113-PCT-GMS

ORDER 

At issue is the Commissioner of Social Security (“Commissioner”)’s denial of 

Plaintiff Timothy Earl O’Neil (“Plaintiff”)’s application for Title II disability insurance 

benefits. Plaintiff filed a Complaint (Doc. 1) seeking judicial review of that denial, and the 

Court now considers Plaintiff’s Opening Brief (Doc. 13, “Pl. Br.”), Commissioner’s 

Response (Doc. 17, “Def. Br.”), Plaintiff’s Reply (Doc. 18), and the Administrative Record 

(Doc. 11, “R.”). Because the Court finds the denial free of legal error and supported by 

substantial evidence, it affirms.

I. BACKGROUND1

Plaintiff filed an application for Title II disability insurance benefits on March 16, 

2015 for a period of disability beginning February 16, 2015 (later amended to July 1, 

1 The Court omits a detailed summary of the medical evidence and opinions and hearing 

testimony and instead will reference relevant evidence and testimony in its analysis.

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2015).2(R. at 15.) Plaintiff’s date last insured (“DLI”) is December 31, 2016. (R. at 18.) 

The application was denied initially on September 9, 2015, and upon reconsideration on 

December 30, 2015. (R. at 15.) Plaintiff then requested a hearing before an administrative 

law judge (“ALJ”), which was held on October 31, 2017. (R. at 15.) On April 23, 2018, the 

ALJ issued an unfavorable decision finding Plaintiff not disabled, which was upheld by the 

Appeals Council on February 20, 2019. (R. at 1–3, 15–28.) This Court has jurisdiction over 

the matter pursuant to 42 U.S.C. § 405(g).

In finding Plaintiff not disabled, the ALJ determined:

[T]he claimant had the residual functional capacity to perform light work as 

defined in 20 CFR § 404.1567(b), except the claimant could sit for about six 

hours, stand and/or walk about four hours out of an eight-hour workday, and 

needed a cane for ambulation and balance. The claimant could occasionally 

climb ramps and stairs, but could never climb ladders, ropes or scaffolds. He 

was able to occasionally balance, stoop, and crouch, but was not able to kneel 

or crawl. The claimant could frequently finger and feel. He should have 

avoided hazards, including unprotected heights, uneven terrain, and moving 

machinery.

(R. at 21.) In formulating this residual functional capacity (“RFC”), the ALJ gave 

“significant weight” to the opinion of Dr. Donald Fruchtman, a consultative examining 

physician, while assigning only “little” or “no weight” to the opinions of Dr. M.A. Kazmi, 

Plaintiff’s treating neurologist. (R. at 25–26.) The ALJ had also rejected Plaintiff’s 

subjective pain and symptom testimony and gave only “some” weight to subjective 

testimony from his family and friends. (R. at 21, 26–27.)

A vocational expert (“VE”) testified at the hearing. (R. at 114–121.) The VE 

testified that an individual with Plaintiff’s RFC could perform past relevant work as a 

compliance director. (R. at 116–117.) The VE further testified, however, that if that 

individual were to be off task for 10% or more of the workday or consistently miss two 

days of work per month, that individual would not be able to sustain full-time employment. 

2 Plaintiff was previously denied disability benefits by an ALJ in February 2015 for an 

application claiming similar impairments filed in June 2012. (R. at 127–138.) Plaintiff did 

not appeal that denial. (R. at 15.) While res judicata ordinarily imposes a continuing 

presumption of non-disability, see Lester v. Chater, 81 F.3d 821, 827 (9th Cir. 1995), the 

ALJ here found Plaintiff overcame that presumption by claiming an impairment in the 

present application that was not previously considered, namely, “adjustment disorder with 

anxiety and depressed mood.” (R. at 15–16.)

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(R. at 117–118.) Moreover, if such an individual could only occasionally handle or finger, 

he would not be able to perform the past relevant work since such work requires the ability 

to use a computer. (R. at 118.) The ALJ found non-disability on the basis of the first 

hypothetical. (R. at 27.)

II. LEGAL STANDARD

In determining whether to reverse an ALJ’s decision, the district court reviews only 

those issues raised by the party challenging the decision. See Lewis v. Apfel, 236 F.3d 503, 

517 n.13 (9th Cir. 2001). The Court may set aside the Commissioner’s disability 

determination only if it is not supported by substantial evidence or is based on legal error. 

Orn v. Astrue, 495 F.3d 625, 630 (9th Cir. 2007). “Substantial evidence” is more than a 

scintilla, but less than a preponderance; it is relevant evidence that a reasonable person 

might accept as adequate to support a conclusion considering the record as a whole. Id. 

“[T]he key question is not whether there is substantial evidence that could support a finding 

of disability, but whether there is substantial evidence to support the Commissioner’s actual 

finding that claimant is not disabled.” Jamerson v. Chater, 112 F.3d 1064, 1067 (9th Cir. 

1997). The Court “must consider the record as a whole and may not affirm simply by 

isolating a specific quantum of supporting evidence.” Orn, 495 F.3d at 630. “Where the 

evidence is susceptible to more than one rational interpretation, one of which supports the 

ALJ’s decision, the ALJ’s conclusion must be upheld.” Thomas v. Barnhart, 278 F.3d 947, 

954 (9th Cir. 2002).

To determine whether a claimant is disabled for purposes of the Act, the ALJ 

follows a five-step process.3 20 C.F.R. § 404.1520(a). The claimant bears the burden of 

3 At step one, the ALJ determines whether the claimant is presently engaging in substantial 

gainful activity. 20 C.F.R. § 404.1520(a)(4)(i). If so, the claimant is not disabled, and the 

inquiry ends. Id. At step two, the ALJ determines whether the claimant has a “severe” 

medically determinable physical or mental impairment. 20 C.F.R. § 404.1520(a)(4)(ii). If 

not, the claimant is not disabled, and the inquiry ends. Id. At step three, the ALJ considers 

whether the claimant’s impairment or combination of impairments meets or medically 

equals an impairment listed in Appendix 1 to Subpart P of 20 C.F.R. Part 404. 20 C.F.R. 

§ 404.1520(a)(4)(iii). If so, the claimant is automatically found to be disabled. Id. If not, 

the ALJ proceeds to step four. Id. At step four, the ALJ assesses the claimant’s residual 

functional capacity (“RFC”) and determines whether the claimant is capable of performing 

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

the inquiry ends. Id. If not, the ALJ proceeds to the final step, where she determines 

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proof on the first four steps, but the burden shifts to the Commissioner at step five. Tackett 

v. Apfel, 180 F.3d 1094, 1098 (9th Cir. 1999). 

The issues before the Court are: (1) whether the ALJ properly rejected the opinions 

of Dr. Kazmi, a treating physician; (2) whether the ALJ properly rejected Plaintiff’s pain 

and symptom testimony; and (3) whether the ALJ properly rejected lay testimony from 

Plaintiff’s family.

III. ANALYSIS

A. The ALJ properly considered the medical opinions.

The determination of a claimant’s RFC is an issue reserved to the Commissioner. 

20 C.F.R. § 404.1527(d)(2). In formulating the RFC, the ALJ evaluates all medical 

opinions in the record and assigns a weight to each. 20 C.F.R. §§ 404.1527(b), 404.1527(c). 

The weight the ALJ gives an opinion depends on a variety of factors, namely: whether the 

physician examined the claimant; the length, nature, and extent of the treatment 

relationship (if any); the degree of support the opinion has, particularly from medical signs 

and laboratory findings; the consistency of the opinion with the record as a whole; the 

physician’s specialization; and “other factors.” 20 C.F.R. §§ 404.1527(c)(1)–

404.1527(c)(6). Additionally, “[i]n conjunction with the relevant regulations, [the Ninth 

Circuit has] developed standards that guide [the] analysis of an ALJ’s weighing of medical 

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

the greatest evidentiary weight is given to opinions of treating physicians; lesser weight is 

given to opinions of non-treating, examining physicians; and the least weight is given to 

opinions of non-treating, non-examining physicians. See Garrison v. Colvin, 759 F.3d 995, 

1012 (9th Cir. 2014). A treating physician’s opinion is entitled to the most weight because

he or she “is employed to cure and has a greater opportunity to know and observe the 

patient as an individual.” Sprague v. Bowen, 812 F.2d 1226, 1230 (9th Cir. 1987); see also 

20 C.F.R. § 404.1527(c)(2). 

whether the claimant can perform any other work in the national economy based on the 

claimant’s RFC, age, education, and work experience. 20 C.F.R. § 404.1520(a)(4)(v). If 

so, the claimant is not disabled. Id. If not, the claimant is disabled. Id.

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An ALJ must resolve any conflicts between medical opinions. Morgan, 169 F.3d at 

601. The ALJ may assign lesser weight to a controverted opinion of a treating physician if 

the ALJ articulates “specific and legitimate reasons supported by substantial evidence.” 

Lester, 81 F.3d at 830. An ALJ may reject any medical opinion that is “brief, conclusory, 

and inadequately supported by clinical findings.” Thomas, 278 F.3d at 957; see Batson v. 

Comm’r of Soc. Sec. Admin., 359 F.3d 1190, 1195 (9th Cir. 2004) (affirming rejection of a 

treating physician’s opinion that “was in the form of a checklist, did not have supportive 

objective evidence, was contradicted by other statements and assessments of [claimant’s] 

medical condition, and was based on [claimant’s] subjective descriptions of pain”). An 

ALJ satisfies the “substantial evidence” requirement by providing a “detailed and thorough 

summary of the facts and conflicting clinical evidence, stating [her] interpretation thereof, 

and making findings.” Garrison, 759 F.3d at 1012. “The opinions of non-treating or nonexamining physicians may also serve as substantial evidence when the opinions are 

consistent with independent clinical findings or other evidence in the record.” Thomas, 278 

F.3d at 957; see also Tonapetyan v. Halter, 242 F.3d 1144, 1149 (9th Cir. 2001) (finding 

examining physician’s opinion constituted “substantial evidence” because it was based on 

his own independent examination of claimant).

1. The ALJ properly weighed the opinion of Dr. Kazmi.

Dr. M.A. Kazmi, Plaintiff’s treating neurologist, completed a “Physical Residual 

Functional Capacity Questionnaire” on July 9, 2015. (R. at 1070–74.) Therein, he opined 

Plaintiff could only sit, stand, or walk for less than two hours in an eight-hour work day 

and would require a job that permitted him to shift positions at will and take unscheduled 

breaks throughout the day. (R. at 1072.) He further opined Plaintiff could “rarely” carry 

and lift up to ten pounds and could “never” carry or lift anything ten pounds or more. (R. 

at 1072.) Plaintiff also could “never” look down, turn his head right or left, look up, or hold 

his head in a static position. (R. at 1073.) He also could “never” twist, stoop, crouch/squat, 

climb ladders, or climb stairs. (R. at 1073.) Further, Plaintiff had “significant limitations” 

with reaching, handling, and fingering. (R. at 1073.) Specifically, he could only use his 

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hands to grasp, turn, or twist objects for 20% of the day; could only use his fingers for fine 

manipulations 5% of the day; and could only use his arms to reach for 5% of the day. (R. 

at 1073.) Dr. Kazmi opined that Plaintiff would miss work more than four days per month, 

which he further specified would be “almost every day.” (R. at 1073.) Lastly, he opined 

Plaintiff would have “constant[]” difficulty concentrating due to pain or other symptoms. 

(R. at 1071.) Moreover, on January 26, 2016 and February 4, 2016, Dr. Kazmi wrote 

correspondence stating that Plaintiff was “unable to work in any capacity due to [his 

multiple medical conditions].” (R. at 1194–95.) Because Dr. Kazmi’s opinion is in conflict 

with the opinion of Dr. Fruchtman, the ALJ’s reasons for assigning it lesser weight must 

be “specific and legitimate” and supported by substantial evidence. Lester, 81 F.3d at 830.

The ALJ assigned “little weight” to Dr. Kazmi’s opinions in the questionnaire, 

finding them “not supported by the objective clinical findings, including those contained 

in [his] own treatment notes.” (R. at 25.) In support, the ALJ referenced notes from Dr. 

Kazmi’s examination of Plaintiff on July 9, 2015, the same day he completed the 

questionnaire, wherein he noted Plaintiff had a “supple” neck with a “full range of motion,” 

a “normal” gait, “normal strength in all four extremities,” and “no deformities or 

abnormalities” in his extremities. (R. at 1078.) He made identical notations at every 

appointment from August 26, 2013, when he first examined Plaintiff, to July 9, 2015.4(R. 

at 1078, 1080, 1083, 1085, 1226, 1229, 1231–32.) Indeed, Dr. Kazmi’s notations regarding 

a full range of motion in Plaintiff’s neck directly contradict his opinion that Plaintiff can 

“never” look down or up, turn his head left or right, or hold his head in static position. With 

regards to Plaintiff’s ability to stand and walk, however, the inconsistency is not as blatant. 

While Dr. Kazmi noted Plaintiff had a “normal gait,” “normal strength in all four 

extremities,” and “no deformities or abnormalities” in his extremities, he simultaneously 

noted Plaintiff experienced “numbness, tingling, [and] pain” in his upper and lower 

extremities. (R. at 1078.) The ALJ did not ignore the latter. Rather, the ALJ acknowledged 

4 At all appointments after July 9, 2015, Dr. Kazmi instead noted Plaintiff had “trouble 

ambulating without support,” “generalized weakness but more prominent in the lower 

extremities,” and “normal” gait with the use of a cane; though he still had a supple neck 

with a full range of motion. (R. at 1213, 1436, 1645, 1647.).

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that these “abnormal findings . . . warrant some restriction in work activity . . . but do not 

justify the extreme limitations provided by Dr. Kazmi.” (R. at 26.) Given that certain 

sections of Dr. Kazmi’s treatment notes suggested Plaintiff had no impairment in his 

extremities (“normal” strength, “no deformities or abnormalities”), the ALJ rationally 

interpreted these notes as inconsistent with the extreme limitations Dr. Kazmi prescribed. 

Nevertheless, the ALJ reached an appropriate middle ground between the conflicting 

notations and determined that Plaintiff did, in fact, have some limitations. As such, the ALJ 

limited Plaintiff’s standing and walking time to four hours a day in the RFC.5 The Court 

finds no error in the ALJ’s decision to give lesser weight to Dr. Kazmi’s assessment based 

on the aforementioned inconsistencies.

Likewise, the ALJ assigned “little weight” to Dr. Kazmi’s opinion regarding 

Plaintiff’s inability to concentrate (R. at 1071) as “not supported by objective testing” and 

“arguably . . . outside of his area of expertise.” (R. at 26.) However, the Ninth Circuit has 

held that despite not being a mental health specialist, a physician may nonetheless provide 

a competent medical opinion as to his patient’s mental functioning. Lester, 81 F.3d at 833. 

As such, the opinion may not be freely disregarded without a legally sufficient reason. 

Nevertheless, an ALJ may consider the specialization of a physician in determining how 

much weight to afford a medical opinion. 20 C.F.R. § 404.1527(c)(5) (“We generally give 

more weight to the medical opinion of a specialist about medical issues related to his or 

her area of specialty than to the medical opinion of a source who is not a specialist.”). 

Moreover, the ALJ may consider the degree of support the medical opinion has from 

objective medical evidence. 20 C.F.R. § 404.1527(c)(3). Here, prior to this assessment, 

there is no documentation by Dr. Kazmi of any impairment relating to Plaintiff’s ability to 

concentrate, nor did Plaintiff ever complain to Dr. Kazmi about any issues with respect to 

concentrating or mental functioning in general. Thus, while the Court finds Dr. Kazmi’s 

opinion regarding Plaintiff’s ability to concentrate to be competent evidence despite it 

5 The consultative examiner, Dr. Fruchtman, opined Plaintiff could walk between four and 

six hours in an eight-hour workday. (R. at 1190.)

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arguably being outside of Dr. Kazmi’s specialty, it also finds the ALJ did not err in 

disregarding it for lack of supporting clinical evidence.6 Thomas, 278 F.3d at 957.

Additionally, Dr. Kazmi opined that Plaintiff would be absent from work for more 

than four days per month “as a result of impairments or treatment,” further elaborating next 

to the box he checked that Plaintiff would be absent “almost every day.” (R. at 1073.) The 

ALJ found this opinion “unpersuasive” for lack of an explanation as to how he arrived at 

this number. (R. at 26.) Specifically, there is no explanation as to how exactly Plaintiff’s 

impairments would preclude him from being able to regularly show up for work. Moreover, 

as noted by the ALJ, “[t]reatment modalities have been conservative.” (R. at 24.) Indeed, 

the record discloses that since the alleged date of onset, July 1, 2015, in not one month did 

Plaintiff see a doctor more than twice, at times even going as long as six months without 

seeing a doctor at all. Thus, there is no substantial evidence to support the conclusion that 

Plaintiff would miss “almost every day” of work due to treatment. The Court finds this 

opinion to be “brief, conclusory, and inadequately supported by clinical findings;” 

therefore, the Court finds no error in its dismissal. Thomas, 278 F.3d at 957.

Lastly, Dr. Kazmi wrote correspondence on January 26, 2016 and February 4, 2016 

opining that Plaintiff was “unable to work in any capacity due to [his multiple medical 

conditions].” (R. at 1194–95.) The ALJ gave this correspondence “no weight,” reasoning 

that it opined to an issue reserved to the Commissioner and “[n]othing in the record 

suggests that Dr. Kazmi has ever worked for or on behalf of the Social Security 

Administration or has any specialized vocational knowledge or familiarity to opine whether 

the claimant can perform work as it exists in the national economy.” (R. at 26.) Indeed, 

whether an individual is “disabled” or “unable to work” is not a medical opinion but rather 

an “administrative finding” that is expressly reserved to the Commissioner. 20 C.F.R. 

§ 404.1527(d)(1). Nevertheless, the ALJ may not ignore such opinions and may only 

6 Plaintiff contends that the ALJ wrongfully omitted explanation of what testing was 

required to support Dr. Kazmi’s opinion regarding Plaintiff’s inability to concentrate. (Pl. 

Br. at 14.) As an adjudicator, it was not within the province of the ALJ to advise Plaintiff 

on what evidence to obtain and present to support his case. See generally 20 C.F.R. 

§ 404.1512 (“Responsibility for evidence.”).

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disregard them for legally sufficient reasons according to the same standard for rejecting 

medical opinions. Reddick v. Chater, 157 F.3d 715, 725 (9th Cir. 1998); SSR-96-5P 

(S.S.A.), 1996 WL 374183, *3 (July 2, 1996). Within the correspondence, Dr. Kazmi 

merely states Plaintiff’s impairments and a bare conclusion that Plaintiff is unable to work 

without discussing or referencing any particular medical evidence to support that 

conclusion, nor does Dr. Kazmi discuss what Plaintiff is capable of doing. Thus, because 

the subject matter of the letter solely regards the ultimate administrative finding of 

disability and nothing more, the ALJ did not err in rejecting it for the specific and legitimate 

reason that Dr. Kazmi did not possess the requisite administrative knowledge to opine to 

this issue.

2. Dr. Fruchtman’s opinion is substantial evidence.

Dr. Donald Fruchtman examined Plaintiff on December 10, 2015 at the behest of 

the Commissioner. (R. at 1184–92.) He observed that Plaintiff was able to get onto the 

exam table but that he became lightheaded upon standing. (R. at 1186.) Plaintiff had regular 

heart rate and rhythm. (R. at 1187.) Plaintiff did, however, have a significantly positive 

Romberg test7and fell backward. (R. at 1187.) Plaintiff did “very well” with squatting, but 

his balance was an issue when he attempted to stand on his toes and heels or on one foot at 

a time. (R. at 1187.) Plaintiff stated that he felt better with regards to his lightheadedness 

and stability when he walked with the cane. (R. at 1188.) Regarding his ranges of motion, 

they were all normal with the exception of some “minimal spasm and tenderness” in the 

cervical and lumbar regions. (R. at 1188.) Regarding his hands, Dr. Fruchtman noted a 

“mild degree of tightness” in tendons in both of his hands and that Plaintiff has Dupuytren’s 

contracture8 of the right and left side. (R. at 1188.) Plaintiff had 5/5 muscle and grip 

strength. (R. at 1189.) Plaintiff had difficult delineating between touch and pinprick. (R. at 

1189.) 

7 This tests an individual’s ability to maintain body balance while the eyes are shut and the 

feet are close together. (Pl. Br. at 7.)

8

“A Dupuytren contracture is contracture of the palmar fascia usually causing the ring and 

little fingers to bend into the palm so that they cannot be extended.” (Pl Br. at 3.)

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Based on his examination, Dr. Fruchtman opined that Plaintiff was able to 

“frequently” carry and lift 10 pounds but could only “occasionally” carry and lift 20 

pounds. (R. at 1191.) He could stand or walk for at least four hours in an eight-hour 

workday and could sit for six to eight hours in an eight-hour workday without limitations. 

(R. at 1191.) He could “frequently” kneel, crawl, reach, and handle; and could 

“occasionally” climb, balance, stoop, or crouch. (R. at 1191.) Dr. Fruchtman also opined 

that Plaintiff could not work in extreme temperatures, with or around chemicals, around 

dust or gas fumes, or around excessive noise. (R. at 1192.) He further opined that Plaintiff 

was not precluded from working due to fatigue. (R. at 1192.)

The ALJ gave “significant weight” to Dr. Fruchtman’s opinion, finding it 

“consistent with the objective clinical findings and the claimant’s reports to his doctors, 

including the neurological deficits, orthostatic dizziness, and pain.” (R. at 25.) The ALJ, 

however, did prescribe greater limitations than Dr. Fruchtman with respect to kneeling or 

crawling after considering Plaintiff’s “subjective complaints of pain, fatigue, and 

dizziness” as well as “the neurological deficits persistently demonstrated on examination.” 

(R. at 25.)

Because Dr. Fruchtman examined Plaintiff and based his opinions on that 

examination, his opinion constitutes substantial evidence that the ALJ was free to use to 

support her decision. See Thomas, 278 F.3d at 957; Tonapetyan, 242 F.3d at 1149.

B. The ALJ properly disregarded Plaintiff’s subjective testimony.

Because the severity of an impairment may be greater than what can be shown by 

objective medical evidence alone, the ALJ considers a claimant’s subjective testimony 

regarding pain and symptoms. 20 C.F.R. § 404.1529(c)(3); Burch v. Barnhart, 400 F.3d 

676, 680 (9th Cir. 2005). The claimant, however, must still show objective medical 

evidence of an underlying impairment that could be reasonably be expected to produce the 

pain or symptoms alleged. 42 U.S.C. § 423(d)(5)(A); 20 C.F.R. § 404.1529(a); see also 

Fair v. Bowen 885 F.2d 597, 603 (9th Cir. 1989) (“An ALJ cannot be required to believe 

every allegation of disabling pain [and symptoms], or else disability benefits would be 

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available for the asking, a result plainly contrary to 42 U.S.C. § 423(d)(5)(A).”). However, 

while such evidence is required to show the existence of an underlying impairment, “the 

[ALJ] may not discredit the claimant’s testimony as to subjective symptoms merely 

because they are unsupported by objective evidence.” Berry v. Astrue, 622 F.3d 1228, 1234 

(9th Cir. 2010). Nevertheless, the ALJ evaluates the testimony in relation to the objective 

medical evidence and other evidence in determining the extent to which the pain or 

symptoms affect his capacity to perform basic work activities. 20 C.F.R. § 404.1529(c)(4).

Unless there is evidence of malingering by the claimant, the ALJ may only reject 

pain or symptom testimony for reasons that are specific, clear, and convincing. Burch, 400 

F.3d at 680. In evaluating the credibility of a claimant’s testimony, the ALJ may consider 

the claimant’s “reputation for truthfulness, inconsistencies either in his testimony or 

between his testimony and his conduct, his daily activities, his work record, and testimony 

from physicians and third parties concerning the nature, severity, and effect of the 

symptoms of which he complains.” Light v. Soc. Sec. Admin., Comm’r, 119 F.3d 789, 792 

(9th Cir. 1997); see 20 C.F.R. § 404.1529(c)(4). General findings pertaining to a claimant’s 

credibility are not sufficient. Lester, 81 F.3d at 821. Rather, “the ALJ must specifically 

identify the testimony she or he finds not to be credible and must explain what evidence 

undermines the testimony.” Holohan v. Massanari, 246 F.3d 1195, 1208 (9th Cir. 2001).

In doing so, the ALJ need not engage in “extensive” analysis but should, at the very least 

“provide some reasoning in order for [a reviewing court] to meaningfully determine 

whether [her] conclusions were supported by substantial evidence.” Brown-Hunter v. 

Colvin, 806 F.3d 487, 494 (9th Cir. 2015). Nevertheless, if the ALJ explains her decision 

“with less than ideal clarity, a reviewing court will not upset the decision on that account 

if [her] path may reasonably be discerned.” Alaska Dept. of Envtl. Conservation v. E.P.A., 

540 U.S. 461, 497 (2004); see Brown-Hunter, 806 F.3d at 492 (applying this rule to the 

social security context).

Here, the ALJ cited no evidence of malingering and found Plaintiff had three 

underlying impairments: (1) diabetes mellitus with neuropathy, (2) orthostatic 

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hypotension, and (3) lumbar and thoracic spine degenerative disc disease. (R. at 18.) The 

ALJ then summarized Plaintiff’s testimony as follows:

The claimant testified he was unable to work due to diabetes, glaucoma, 

vision loss, neuropathy, and pain symptoms. The claimant testified the 

diabetes was causing problems with his nervous system and organs. He stated 

he was going blind in his right eye. He stated he has neuropathy in his hands 

and no longer had a sensation to urinate. The claimant testified he 

experienced severe hand pain, feet pain, chest pain, and back pain. He stated 

he experiences trigeminal neuralgia multiple times each day. The claimant 

testified he spent most of his day doing physical therapy, hydrotherapy, yoga, 

sitting, and wandering around the house. He stated he could not drive, but 

occasionally go to the store. He stated he had difficulty concentrating, but 

could use a tablet to check emails and delete them. The claimant stated he 

does not use the tablet for anything else.

(R. at 21, 95–111.) The ALJ rejected Plaintiff’s testimony for two reasons. First, she found 

it “not entirely consistent with the medical evidence and other evidence in the record.” (R. 

at 21.) The ALJ analyzed the evidence and testimony for each impairment separately.

First, with regards to Plaintiff’s diabetes mellitus, the ALJ cited to a number of 

treatment records in finding that Plaintiff’s pain and symptoms associated with diabetes 

mellitus were not work-preclusive. Specifically, she referenced the same previously 

discussed treatment notes from Dr. Kazmi where Plaintiff was noted as having a normal 

gait and normal strength in his extremities (R. at 1078), but additionally noting ones that 

indicated Plaintiff had weakness more prominent in the lower extremities and coordination 

issues upon sudden standing (R. at 1213). (R. at 23.) She also pointed out that Dr. Kazmi 

noted Plaintiff had difficulty ambulating without support and a normal gait but with the use 

of a cane. (R. at 1436.) However, she noted that a diabetic foot exam on August 26, 2016 

was “normal.” (R. at 23.) 

The ALJ found that notwithstanding Plaintiff’s complications due to diabetic 

neuropathy he is capable of working at the light exertional level. (R. at 22.) The ALJ 

prescribed the “light” exertional level, specifically recognizing that Plaintiff has persistent 

neurological deficits that affect his hands and feet. (R. at 22.) Moreover, she limited the 

amount of time he stands or walks to four hours, provided for use of a cane, proscribed 

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work at heights and around other hazards, and limited the type and frequency of postural 

and manipulation activities to account for neurological deficits in his lower extremities. (R. 

at 23.) Thus, the Court finds no error in the ALJ’s consideration of Plaintiff’s testimony

with respect to his diabetic neuropathy as she appropriately accommodated his limitations

in the RFC. (R. at 21.) 

Second, with regards to Plaintiff’s orthostatic hypotension,9the ALJ noted Plaintiff 

had a positive tilt table test, which indicated Plaintiff has orthostatic hypotension. (R. at 

22, 1348.) On December 11, 2015, Plaintiff presented to Dr. Fadi Atassi, a cardiologist, for 

evaluation of chest pain. (R. at 1210.) The ALJ noted Plaintiff told Dr. Atassi that when 

the pain becomes significant, he experiences shortness of breath and dizziness. (R. at 1210.) 

Moreover, Plaintiff reported only shortness of breath and dizziness, but no loss of 

consciousness, weakness, numbness seizures, headaches, chest pain, arm pain on exertion, 

or palpitations, as further noted by the ALJ. (R. at 22, 1210.) The ALJ also noted that as of 

March 19, 2015, Plaintiff had not had any “true syncopal episodes,” but that he “does get 

orthostatic dizziness.” (R. at 22, 1339.) The ALJ thus concluded that “the claimant’s 

cardiac records do not support persistent cardiac symptoms, other than orthostatic 

dizziness.” (R. at 22.) Nevertheless, the ALJ did take Plaintiff’s complaints of orthostatic 

dizziness into account. Specifically, she limited the time he could stand and/or walk; 

provided for the use of a cane to aid in his balancing; and proscribed working at heights, 

in uneven terrain, and around moving machinery. (R. at 21, 22.) She also provided for 

decreased stooping and crouching and prohibited kneeling and crawling to reduce the 

chances of triggering his orthostatic dizziness. (R. at 21, 22.)

However, Plaintiff alleges the ALJ improperly disregarded his testimony regarding 

the intensity, persistence, and limiting effects of his orthostatic dizziness. Specifically, 

Plaintiff argues the ALJ’s conclusion that he was “‘doing good’ from a cardiac perspective” 

(R. at 22) does nothing to undermine his testimony regarding the severity of his orthostatic 

9

“Orthostatic hypotension is a decrease in systolic and diastolic blood pressure to below 

normal when a person assumes an upright position after getting up from a bed or chair.” 

(Pl. Br. at 3.)

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dizziness. (Pl. Br. at 18.) He alleges that the orthostatic dizziness is “not cardiac related, 

but caused by autonomic neuropathy.”10 (Pl. Br. at 18). 

However, Plaintiff presented to Dr. Atassi, a cardiologist, for evaluation of his chest 

pain. (R. at 1210.) It was Plaintiff who told Dr. Atassi that his chest pain leads to dizziness. 

(R. at 1210.) Thus, Dr. Atassi was employed to diagnose and treat Plaintiff’s dizziness. As 

such, the ALJ did not err in discussing and citing to records and opinions from Dr. Atassi 

as they were records relevant to Plaintiff’s dizziness. Moreover, Plaintiff informs the Court 

that orthostatic hypotension entails a “decrease in systolic and diastolic blood pressure.” 

(Pl. Br. at 3.) Thus, even a lay person, such as the ALJ, can make the rational interpretation 

that the heart, an organ which pumps blood, is implicated by orthostatic hypotension. For 

these reasons, the Court will not disturb the ALJ’s rational interpretation of the record and 

finds no error in the ALJ’s rejection of Plaintiff’s testimony as it relates to his orthostatic 

hypotension.11

Third, with regards to Plaintiff’s degenerative disc disease, the ALJ noted, “a 

thoracic spine x-ray revealed straightening of the normal thoracic spine with no 

compression fracture or significant malalignment. It showed mild degenerative discogenic 

disease in the lower lumbar spine, but no spondylolisthesis or significant malalignment.” 

(R. at 23, 1169.) The ALJ also noted, “a thoracic spine MRI revealed a disc protrusion at 

T7-8 and T8-9, otherwise it was unremarkable.” (R. at 23, 1306.) She remarked that “the 

clinical findings from physician examinations do not support the degree of symptoms the 

claimant has alleged”; “the physician examinations primarily revealed neurological 

10 The Court notes an EMG done on September 4, 2013 showed “sympathetic skin 

responses were present in all four extremities, suggesting minimal if any autonomic 

neuropathy.” (R. at 827.) Moreover, Plaintiff testified at a prior disability hearing that he 

had workup done at the Mayo Clinic and the doctors there diagnosed cardiac autonomic 

neuropathy as the cause of his chest pain. (R. at 52.) However, there are no records from 

the Mayo Clinic in the record before the Court.

11 Even if, arguendo, the ALJ had improperly (irrationally) concluded that orthostatic 

hypotension is a cardiac rather than a neurological issue, as Plaintiff interprets it (R. at 18), 

such an error would be harmless as “inconsequential to the ultimate nondisability 

determination.” Stout v. Comm’r, Soc. Sec. Admin., 454 F.3d 1050, 1055 (9th Cir. 2006). 

Specifically, the ALJ found—regardless of its etiology—that the dizziness Plaintiff 

experiences is not work-preclusive. While it does hinder his ability to engage in some work 

activity, the ALJ put appropriate restrictions in his RFC.

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findings discussed above but showed little with regard to the claimant’s spinal 

impairment.” (R. at 23.)

Thus, the ALJ concluded that “the clinical findings reported in the progress notes 

focus on neurological signs; there is little in the way of orthopedic signs, such as decreased 

or painful range of motion, decreased strength,12 muscle atrophy, or tenderness to 

palpation.” (R. at 24.) Nevertheless, the ALJ accommodated Plaintiff’s subjective reports 

of back pain in the RFC by prescribing a light exertional level and restrictions in postural 

activities. (R. at 21, 24.)

The second reason the ALJ discounted Plaintiff’s testimony was because Plaintiff 

“has not generally received the level of medical treatment one would expect for a disabled 

individual,” noting that “[t]reatment modalities have been conservative.” (R. at 24.) 

Specifically, the ALJ argued that “with claimant’s alleged severity of pain and limitations, 

one would expect more significant findings on both the diagnostic imaging and exams, as 

well as more complex treatment.” (R. at 24.) She noted that Plaintiff was never 

recommended surgery or underwent more invasive procedures, such as epidural injections 

or nerve ablations. (R. at 24.) This all stands for the ALJ’s proposition that if Plaintiff’s 

pain and symptoms were really as severe as alleged, he would be doing more for them, 

instead of merely taking “routine prescription medication” and engaging in other home 

remedies such as hydrotherapy and yoga. (R. at 24.)

This reason is sufficient. See Parra v. Astrue, 481 F.3d 742, 751 (9th Cir. 2007) 

(“[E]vidence of conservative treatment is sufficient to discount a claimant’s testimony 

regarding severity of an impairment.”) (internal quotations and citation omitted). An ALJ 

is free to take into account the amount of treatment a claimant receives for an impairment

in determining the nature and severity of the impairment, as well as medication and any 

other measures used. 20 C.F.R. §§ 404.1529(c)(3)(iv)–404.1529(c)(3)(vi). Thus, the Court 

finds no error here.

12 The Court notes and clarifies that while Plaintiff did exhibit decreased strength in his 

lower extremities as noted by Dr. Kazmi and as previously discussed, the ALJ here is 

referring to the lack of a finding of decreased strength in Plaintiff’s spine in particular.

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The ALJ committed no legal errors in considering the entirety of Plaintiff’s 

subjective testimony. Although a lack of objective medical evidence cannot be the sole 

basis on which a claimant’s testimony is rejected, it is still a factor that the ALJ may

consider. Burch, 400 F.3d at 681. Here, the lack of objective medical evidence showing 

“more significant findings on both the diagnostic imaging and exams” (R. at 24) in 

combination with Plaintiff’s conservative treatment is sufficient to discount his testimony. 

Though, in actuality, the ALJ did not discount the entirety of his testimony. Rather, the 

ALJ had made appropriate accommodations and restrictions in the RFC to account for 

Plaintiff’s subjective complaints. Simply because these complaints did not give rise to a 

finding of disability does not warrant a reversal where the ALJ rationally interpreted the 

record and based her conclusions on substantial evidence therein. 

C. The ALJ properly disregarded lay testimony.

Nonmedical (“lay witness”) sources may testify as to how a claimant’s symptoms 

affect his activities of daily living and ability to work. 20 C.F.R. § 404.1529(a). Such 

testimony is “competent evidence” that an ALJ may not disregard unless he or she gives 

“reasons germane to each witness for doing so.” Diedrich v. Berryhill, 874 F.3d 634, 640 

(9th Cir. 2017) (internal quotations and citation omitted).

The record contains several lay opinions from Plaintiff’s family and friends. (R. at 

438–450, 486–487.) The ALJ gave “some weight” to all of the lay opinions collectively, 

reasoning that none of the witnesses “have the appropriate psychological or medical 

training to make exacting observations, diagnoses, and determine mental or physical 

limitations.” (R. at 26–27.) Moreover, according to the ALJ, “[t]heir statements seem to 

identify the symptoms from the impairments, but the medical evidence and opinions do not 

fully support their opinions.” (R. at 27.) Plaintiff disputes only the rejection of the opinions 

of his wife, Kathie O’Neil; son, Michael O’Neil; and sister-in-law, Terrie Sage. (Pl. Br. at 

20.) 

In her correspondence, Kathie O’Neil describes Plaintiff’s inability to not sit or 

stand long, his need for something to hold onto for balance, his inability to use his hands 

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effectively, and what his pain is like when he does not take his medication. (R. at 438.) 

Similarly, Michael O’Neil describes Plaintiff’s inability to walk without support, his 

lightheadedness, his medication requirements, and his forgetfulness. (R. at 447–448.) 

Lastly, Terrie Sage also described Plaintiff’s pain, loss of concentration, lack of balance, 

dizziness, and need for support. (R. at 442.)

Here, because the ALJ properly rejected Plaintiff’s subjective complaints, the Court 

finds the lay third-party opinions are properly rejected as well as they regard similar 

symptoms and complaints thereof. See Valentine v. Comm’r Soc. Sec. Admin., 574 F.3d 

685, 694 (9th Cir. 2009) (holding that because “the ALJ provided clear and convincing 

reasons for rejecting [the claimant’s] own subjective complaints, and because [the 

claimant’s] testimony was similar to such complaints, it follows that the ALJ also gave 

germane reasons for rejecting [the lay witness’s] testimony”).

IT IS THEREFORE ORDERED affirming the April 23, 2018 decision of 

Administrative Law Judge Kelly Walls, as upheld by the Appeals Council on February 20, 

2019.

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

accordingly and terminate this matter.

Dated this 27th day of January, 2020.

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