Document ID: s3://data.kl3m.ai/documents/govinfo/USCOURTS/USCOURTS-caed-1_14-cv-00296/USCOURTS-caed-1_14-cv-00296-3/pdf.json

Parties Involved:
Commissioner of Social Security
Defendant
Corry Flores Navarro
Plaintiff

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UNITED STATES DISTRICT COURT

EASTERN DISTRICT OF CALIFORNIA

INTRODUCTION

Plaintiff Corry Flores Navarro (“Plaintiff”) seeks judicial review of a final decision of the 

Commissioner of Social Security (“Commissioner”) denying his application for disability insurance 

benefits (“DIB”) pursuant to Title II of the Social Security Act and for supplemental security income 

(“SSI”) under 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 Magistrate Judge Barbara A. 

McAuliffe. The parties consented to the jurisdiction of the Magistrate Judge. The Court finds the 

decision of the Administrative Law Judge (“ALJ”) to be supported by substantial evidence in the 

record as a whole and based upon proper legal standards. Accordingly, this Court affirms the agency’s 

determination to deny benefits.

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CORRY FLORES NAVARRO,

 Plaintiff,

v.

CAROLYN W. COLVIN, Acting 

Commissioner of Social Security,

Defendant.

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Case No.: 1:14-cv-00296-BAM

ORDER REGARDING PLAINTIFF’S

SOCIAL SECURITY COMPLAINT

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FACTS AND PRIOR PROCEEDINGS

On January 7, 2011, Plaintiff filed an application for disability insurance benefits and 

supplemental security income. AR 210-222.

1

 Plaintiff alleged that he became disabled on June 30, 

2009. AR 9. Plaintiff’s application was denied initially and on reconsideration. AR 128-132, 135-

140. Subsequently, Plaintiff requested a hearing before an Administrative Law Judge (“ALJ”). ALJ 

Christopher Larsen held a hearing on September 27, 2012, and issued an order denying benefits on

November 2, 2012. AR 6-18. Plaintiff sought review of the ALJ’s decision, which the Appeals 

Council denied, making the ALJ’s decision the Commissioner’s final decision. AR 1-3, 5. This 

appeal followed.

Hearing Testimony

The ALJ held a hearing on September 12, 2012, in Fresno, California. AR 26-52. Plaintiff 

appeared and testified. AR 28. He was represented by attorney Gina Fazio. AR 28. Impartial 

Vocational Expert (“VE”) Thomas Dachelet also testified. AR 28, 46.

Plaintiff primarily alleged disability due to problems with hypertension, and his sleep, heart, 

vision, depression, knees and wrists. AR 128. At age 31, he was 5’9’ tall and weighed about 400

pounds. His normal weight should be 180, which he last weighed as a junior in high school. His 

weight is usually around 400. AR 32. 

In response to questioning from his counsel, Plaintiff testified that he graduated from high 

school. He also attended a business college for medical assistant training, but only attended for eight 

months and did not complete the program. AR 33.

Plaintiff last worked as a temp driving a forklift in November 2011 for approximately 9 days, 

but stopped because he was hearing a lot of voices. He did not work in 2010. In the last 15 years, he 

has worked as a forklift operator and performed general labor at a raisin company for three years. He 

also drove a forklift at other jobs during the last fifteen years. However, he kept hearing voices that 

made him paranoid. AR 33-34.

 

1 References to the Administrative Record will be designated as “AR,” followed by the appropriate page number.

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Plaintiff testified that the other physical problems keeping him from working are his vision, 

wrists, feet, knees, pain and arthritis. He also has “keratoconus,” an eye disease, which even with his 

glasses causes blurry vision. He has problems with distance vision, but can read close up with his left 

eye. Despite his vision problems, he drives during the day about two or three times a week. He does 

not drive at night because he cannot see the signs. AR 34-35.

Plaintiff has carpal tunnel in his wrists and explained that he had hard jobs in the past where he 

was using his wrists and arms. If he starts using his wrists and arms now, they get numb with sharp, 

stabbing pains in each wrist. It may happen when he lifts heavy things weighing about 25 pounds. He 

does not have trouble opening jars with a rag or towel. He can hold smaller things like pens and 

pencils, but gets numb. He also gets numb in his hands if he is driving, so he has to stop and use them 

one at a time. Plaintiff testified that he has medicine for the pain, but it does not get rid of the 

numbness. He has to pull them so the blood circulates through and he gets the feeling back. AR 35-

37.

Plaintiff testified that he also will get sharp, stabbing pains in his foot, mainly on his right. 

The more he moves around, walking and standing, the more pain he gets. He also has pain when he is 

just sitting down. Plaintiff believed he could walk or be on his feet about 2 hours before he would 

have to sit down. His knees will start to hurt and crack, along with his ankles. AR 35-37.

Plaintiff has been trying to lose weight, and had lost 70 pounds by eating less and walking. He 

walks every three days because after walking his joints are inflamed. Plaintiff tries to walk two hours 

with a cane/big staff. He has been using a cane for two years, but it was not prescribed for him. 

Plaintiff could not walk for two hours every day because of joint pain. He would need about two days 

off after walking to rest his feet. AR 37-40. Plaintiff indicated that he can sit for a long time before he 

has to stand. He also can lift about 20 pounds comfortably. AR 46. 

Plaintiff testified that he does not want to go out because the voices mess with him and he 

hears things every day. He even heard something in the waiting room. He hears things more often

when he is in a group or in an area with a lot of people. Plaintiff testified that he liked to isolate 

himself because he is tired of hearing “this stuff.” AR 40. He takes medication, which helps a little 

bit. AR 40. He also takes medication for pain, but cannot mix it with his psychiatric medicine. He 

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takes pain medication every other day or when he is walking. He also uses Bengay and Icy Hot for 

pain. AR 40-41.

When questioned about his activities of daily living, Plaintiff reported that he lives in a house 

with his parents and, during the day, he watches TV for about two to three hours and tries to take care 

of the lawn by watering it with a sprinkler. Plaintiff also helps with some chores inside the house. He 

washes his clothes, can cook and does not have a problem mopping or vacuuming. He can take care 

of personal things, like dressing and bathing without help. He does not have any hobbies and does not 

visit friends because of his mental illness. Plaintiff explained that he lost all his friends and he does 

not go to family functions because he hears his family saying things. Since he has been taking a pill, it 

does not bother him as much, and he does not hear things that wake him up. He sleeps four to five 

hours a night, sometimes eight. The medication makes it hard for him to stay awake during the day 

and he will pass out while watching TV. He sleeps about three hours during the day. He also has to 

put his feet up to get comfortable. He had edema in his legs, so his mom told him it was better to put 

his feet up. He probably spends about two hours a day with his feet up. AR 41-43. 

Plaintiff testified that he goes grocery shopping by himself once or twice a month. He usually 

goes during the day because he thinks people know him, know all about him and he hates it. He tries 

to go to church, but starts hearing things there, too. AR 44-45. 

When asked about his medications, Plaintiff reported that his schizophrenia medication makes 

him nervous and anxious, but he takes a side effect pill to feel a little bit better. The painkillers put 

him to sleep and he cannot mix them much with the schizophrenia drug. Plaintiff stated that the 

doctor said not to mix Tramadol with Geodon. AR 45.

Following Plaintiff’s testimony, the ALJ elicited testimony from the vocational expert (“VE”) 

Thomas Dachelet. AR 46. The VE testified that Plaintiff’s past work was classified as warehouse 

laborer and forklift operator, which would be performed together. AR 47. The ALJ asked the VE 

hypothetical questions, contemplating an individual of claimant’s age, education, and work 

experience. AR 47. In his first hypothetical, the ALJ asked the VE to assume a worker who can lift 

and carry 50 pounds occasionally and 25 pounds frequently, can stand and walk for six hours in a day, 

can sit six hours in day, can frequently climb, balance, stoop, kneel, crouch and crawl and can 

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frequently reach, handle, finger and feel. The VE testified that such an individual could perform 

Plaintiff’s past job, along with other jobs in the economy, such as hand packager, machine packager, 

and laborer-poultry. AR 48. 

In a second hypothetical, the ALJ asked the VE to consider a worker who is capable of light 

physical exertion, but can never climb ladders, ropes, or scaffolds, can frequently balance, stoop, 

kneel, crouch, crawl, and climb ramps or stairs, and must avoid even moderate exposure to fumes, 

odors, dusts, gasses, and poor ventilation. The VE stated that this worker could not perform Plaintiff’s 

past work because of the fumes from the forklift. However, this worker could perform other jobs in 

the economy, such as packing line worker, garment sorter, and ampoule filler. AR 49.

In a third hypothetical, the ALJ asked the VE to consider a worker who can lift and carry 20 

pounds occasionally, 10 pounds frequently, can stand and walk about two hours in an eight hour day, 

and can sit about six hours in an eight hour day, but must elevate his feet about two hours per day. 

This worker also can never climb ladders, ropes or scaffolds, can occasionally balance, stoop, kneel, 

crouch, crawl, and climb ramps or stairs, can frequently reach, handle, finger and feel, and can 

perform simple, repetitive tasks without public contact. According to the VE, Plaintiff’s past jobs 

were out and the world of work would be closed to this worker. AR 50. 

In a final hypothetical, the ALJ asked the VE to consider a worker who cannot complete an 

eight hour work day or a 40-hour work week without interruption from psychologically based 

symptoms. The VE testified that the world of work would be closed. AR 50-51. 

Medical Record

The entire medical record was reviewed by the Court. AR 361-571. The medical evidence, 

summarized here, will also be referenced below as necessary to this Court’s decision. 

In 2007, polysomnography testing revealed severe obstructive sleep apnea and nasal CPAP 

titration. It was recommended that Plaintiff consider weight loss to an ideal body weight and nasal 

CPAP at 17 cm of pressure. AR 366-371. 

In 2008, Plaintiff received follow-up treatment for his severe obstructive sleep apnea and 

morbid obesity. AR 363-365. In March 2008, Plaintiff was instructed to lose weight or consider 

possible weight reduction surgery. On examination, he had 2+ pedal edema. AR 363.

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In June 2008, Paul Klein, PsyD, a state agency psychologist, completed a Psychiatric Review 

Technique and opined that Plaintiff’s affective disorder (depressive sxs) was not severe. Plaintiff had 

mild restrictions in his activities of daily living, mild difficulties in maintaining social functioning, and 

mild difficulties in concentration, persistence or pace, but no repeated episodes of decompensation. 

AR 375-385. 

Also in June 2008, Dr. Paul Frye, a state agency physician, completed a Residual Functional 

Capacity Assessment. Dr. Frye opined that Plaintiff could lift and carry 20 pounds occasionally, 10 

pounds frequently, stand and walk about 6 hours in an 8-hour workday, sit about 6 hours in an 8-hour 

workday and push or pull without limitation. He could never climb a ladder, rope, or scaffolds, but 

had no other postural limitations. He also had no manipulative, visual or communicative limitations, 

but had environmental restrictions to avoid even moderate exposure to fumes, odors, dusts, gasses, and 

poor ventilation. AR 392-396. In a case analysis, Dr. Frye noted that Plaintiff had severe obstructive 

sleep apnea, was super, super obese and had early signs of metabolic syndrome. Dr. Frye opined that 

light work was appropriate with respiratory and postural limitations. AR 386-387.

In July 2008, Plaintiff received follow-up treatment for his sleep apnea. Plaintiff reported that 

he had been walking 2 hours every 2 days, and at least 1 hour each day. However, during the 

examination, Plaintiff complained of knee pain and cracking. AR 402. 

In June 2009, Plaintiff sought follow-up treatment for his depression. Plaintiff had been taking 

his Prozac, but was experiencing restlessness, especially restless legs, keeping him up at night. 

Plaintiff reported that his depression had been much better and he felt like he could function better on 

a daily basis without feeling down. On psychiatric evaluation, Plaintiff’s mood seemed elevated. 

Plaintiff’s treating physician discontinued Prozac and started him on Sertraline. AR 420-421. 

In November 2009, Plaintiff was directed to undergo a sleep study for his sleep apnea. AR 

437. 

In January 2010, Plaintiff stated that he had started taking Prozac, but it was not helping. His 

prescription was changed to Zoloft. AR 419. 

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In February 2010, Plaintiff reported that he had not started Zoloft yet, and his depression was 

somewhat better. Plaintiff’s treating physician encouraged him to start meds to help with depression 

symptoms. AR 418. 

On June 16, 2010, Plaintiff reportedly stopped taking Zoloft and started Prozac, which helped 

with depression, but not anxiety in social situations. AR 417. 

On February 15, 2011, Plaintiff sought treatment for pain in his wrist, knees and ankle. AR 

434. X-rays of the wrists completed on February 16, 2011, showed findings consistent with a tear of 

the scapholunate ligament of the left and right wrists, narrowing of the radial scaphoid radiocarpal 

joints on the right wrist and an ulnar minus variance of the left wrist. AR 426-427. 

On February 25, 2011, Plaintiff underwent testing for his complaints of pain in both hands 

along with numbness and weakness. The electrophysiological study showed evidence of bilateral, 

right worse than left, motor, sensory median neuropathy across the wrists suggestive of bilateral 

moderate to severe, right worse than left, carpal tunnel syndrome with no coexisting evidence of 

polyneuropathy, myopathy or radiculopathy. AR 424-425. Nerve conduction studies of Plaintiff’s 

wrists and elbows were completed on March 10, 2011. AR 491-492. 

On March 4, 2011, Plaintiff sought emergency treatment for foot pain and swelling. X-rays of 

his left and right foot revealed soft tissue swelling. AR 520-526.

On April 27, 2011, Dr. Tomas Rios, a board certified physician, completed a comprehensive 

internal medicine evaluation. Plaintiff’s chief complaints included pain in his knees to the ankle area, 

sleep apnea and bilateral wrist pain. On physical examination, Plaintiff was identified as obese at 5’9” 

and 417 pounds. He walked with a slight limp favoring the left side, but his tandem walk was normal. 

Examination of both knees revealed crepitation, but no effusion. There was some tenderness on 

palpation of the medial compartment bilaterally, but no collapsing weakness. Plaintiff’s wrists were 

negative for Tinel’s and Phalen’s signs. His fine and gross finger manipulations appeared preserved. 

His strength was 5/5 throughout with normal muscle bulk and tone. Dr. Rios diagnosed Plaintiff with 

degenerative joint disease, sleep apnea syndrome, and carpal tunnel syndrome suspect. Dr. Rios 

opined that Plaintiff could stand and walk up to six hours and sit up to six hours. He could lift and 

carry 50 pounds occasionally and 25 pounds frequently. He frequently could climb, balance, stoop, 

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kneel, crouch and crawl. He also could frequently reach, handle, finger and feel. He had no 

workplace environmental limitations. AR 447-451.

On May 1, 2011, Dr. Gil Schmidt, a psychologist, completed a comprehensive psychiatric 

evaluation. Upon initial greeting in the lobby, Plaintiff’s behavior, mood and gait all appeared within 

normal limits. Plaintiff’s chief complaints included anxiety, bipolar, depression, hearing voices, 

physical pain and stress. Plaintiff reported that he did not like being around anyone and had moody 

thoughts that caused mood swings. He had gained 150-200 pounds in the last 10 years and currently 

weighed 417. Plaintiff indicated that he began taking psychiatric medication in 2004. After losing his 

last job as a forklift operator, he became depressed and sought treatment from his primary care 

physician. He reported no significant side effects from any medications and had tried Lexapro, Zoloft 

and Prozac. In 2004, he also attended drug and alcohol counseling. Additionally, Plaintiff reported a 

psych hospitalization in 2010, a 5150 for drinking alcohol and taking Prozac together. He also started 

talking to himself, became agitated and was put into a program for 24-hour observation. Plaintiff 

indicated that he last worked in 2007, and quit because people get him upset and comment on his 

weight. He has worked as a forklift operator, packing warehouseman and cook. 

When describing his activities of daily living, Plaintiff reported he showered on a daily basis, 

can prepare and cook his own meals and can take care of his own hygiene. He sleeps from 9-10 hours 

at a time with repeated awakenings due to sleep apnea. He does not need to take naps and he denied 

insomnia, early awakening and repetitive nightmares. He is capable of both light and heavy duty 

domestic chores only limited by his excessive weight. 

On mental status examination, Plaintiff made appropriate eye contact, his gait appeared slow 

due to excessive weight and his energy was within normal limits. His attitude was negative, but he 

was pleasant, cooperative and responsive to exam questions. His stream of mental activity/speech was 

within normal limits as to pace, volume and inflection. His content of thought was within normal 

limits. Dr. Schmidt indicated that while Plaintiff reported auditory hallucinations, he also reported 

experiencing demonic voices outside of his room, which were much more prominent when he was 

doing drugs and it had been over a year since he last experienced it. His affect was congruent and 

spontaneous with smiles, his mood was within normal limits and he did not appear overly anxious. 

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Plaintiff’s long-term, short-term and working memory appeared intact and functional. His fund of 

knowledge was within normal limits and he could perform simple daily money calculations. 

Plaintiff’s concentration was within normal limits, he demonstrated an adequate range of affect of 

expression and appropriate social cueing, his responses suggested cognitive thinking intact at the 

concrete level of reasoning and his judgment/insight appeared average. 

Following examination, Dr. Schmidt opined that Plaintiff’s functional level appeared to be 

adequate with no significant mental health impairment. He diagnosed Plaintiff with depression, 

assigned a GAF of 71-80, no significant impairment, and found Plaintiff’s degree of mental health 

functioning to be unremarkable. Plaintiff had no impairment of his work related abilities. Plaintiff’s 

reported psychotic intrusions appeared to be related to his symptoms of past drug abuse. AR 438-444. 

A May 4, 2011 x-ray of Plaintiff’s left knee showed mild joint space narrowing medially, but 

was otherwise normal. No acute or other preexisting abnormality was detected. AR 446.

On May 16, 2011, Dr. J. Frankel, a state agency physician, completed a Physical Residual 

Functional Capacity Assessment form. Dr. Frankel opined that Plaintiff could lift and carry 50 pounds 

occasionally, 25 pounds frequently, could stand and walk about 6 hours in an 8-hour workday, sit 

about 6 hours in an 8-hour workday and could push and pull without limitation. He could never climb 

ladders, ropes or scaffolds, but frequently could climb ramps and stairs. He also occasionally could 

stoop, kneel, crouch and crawl. He had no manipulative or visual limitations. However, he should 

avoid concentrated exposure to extreme cold, extreme heat, wetness, humidity, fumes and hazards. 

AR 452-456.

On May 30, 2011, PY Klein, PsyD, a state agency consultant, completed a Psychiatric Review 

Technique form. Dr. Klein opined that Plaintiff’s affective disorder (depressive d/o nos) was not a 

severe impairment. Plaintiff had no restriction of his activities of daily living, no difficulties in 

maintaining social functioning, no difficulties in maintaining concentration, persistence or pace and no 

repeated episodes of decompensation. AR 459-472.

In September 2011, Plaintiff sought follow-up treatment for his morbid obesity and complaints 

of knee pain. A review of systems was negative. On examination, Plaintiff had 5/5 motor strength in 

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his upper and lower extremities and a normal gait. He was provided naproxen for his knee pain and a 

referral to elective surgery services for his obesity. AR 504-507.

On October 5, 2011, Dr. E. Matsuyama, a state agency physician, completed a Physical 

Residual Functional Capacity Assessment. Dr. Matsuyama opined that Plaintiff could lift and carry 50 

pounds occasionally, 25 pounds frequently, could stand and walk about 6 hours in an 8-hour workday, 

could sit about 6 hours in 8-hour workday and could push and pull without limitation. Plaintiff could 

occasionally climb ramps or stairs, but never climb ladders, ropes or scaffolds. In his assessment, Dr. 

Matsuyama noted that Plaintiff had EMG testing done on both wrists and was diagnosed as having 

bilateral moderate to severe carpal tunnel syndrome. He occasionally could balance, stoop, kneel, 

crouch and crawl. He had no manipulative, communicative or environmental limitations, but was 

limited in his far acuity. AR 508-515.

On December 22, 2011, Plaintiff reported that he had been denied bariatric surgery and was 

depressed due to his weight. His treating physician prescribed Paxil. AR 562-571.

On March 29, 2012, Plaintiff sought follow-up treatment for his obesity and depression. 

Plaintiff reported that he had lost weight with exercise and diet, but had chronic knee pain due to 

weight. He identified little improvement with Paxil and began taking some old lithium pills believing 

they would help with his depression. Plaintiff’s treating physician advised him to stop taking the 

lithium, gave him the number for mental health services and increased his Paxil. AR 547-556.

On April 30, 2012, Plaintiff underwent an evaluation by Veronica De Alba, a licensed clinical 

social worker with Fresno County Mental Health. He reportedly was referred for services because he 

was struggling with auditory hallucinations, paranoia and depression. Ms. De Alba diagnosed Plaintiff 

with a psychotic disorder, NOS, and opined that he had a significant impairment requiring mental 

health treatment. Ms. De Alba also opined that Plaintiff was impaired in his living arrangements, 

employment, daily activities, social relationships and health. AR 539-541.

On May 30, 2012, Dr. Robert T. Ensom conducted a Psychiatric Evaluation based on 

Plaintiff’s complaint that he always hears voices, which make derogatory statements. On mental 

status exam, Plaintiff’s affect was appropriate, but his mood was depressed and anxious. His speech 

was normal and his thought processes were intact. Plaintiff reported auditory hallucinations, along 

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with rare instances of tactile hallucinations, like a mouse crawling on him or tasting pee he thought his 

family put in his food. He had persecutory delusions, with mild impaired judgment. Dr. Ensom 

diagnosed Plaintiff with a psychotic disorder, NOS. AR 536-538.

On June 13, 2012, Plaintiff saw Dr. Ensom for medication management. Plaintiff reported 

taking Prolixin and feeling “real nervous” in his arms and legs. The second day, it was intolerable and 

he stopped taking Prolixin. On mental status, Plaintiff’s behavior, speech, sensorium and affect were 

within normal limits. It was noted that Plaintiff’s hearing of severe voices caused relational conflict. 

AR 535. 

On June 27, 2012, Plaintiff saw Dr. Ensom for medication management. Plaintiff reported 

very little improvement in restlessness and did not want to take Prolixin or go outside. On mental 

status, his behavior, speech, sensorium and affect were within normal limits. Dr. Ensom stopped 

Prolixin, increased Paxil and prescribed Geodon. AR 534. 

On July 11, 2012, Plaintiff saw Dr. Ensom for psychiatric medication follow-up. Plaintiff 

reported that his restlessness was better with his current medications. Although he still heard auditory 

hallucinations from family members and neighbors, which woke him with voices and tugging on his 

shirt, sometimes demonic, it was less. On mental status, Plaintiff’s behavior, speech, sensorium and 

affect were within normal limits. His medications included Geodon, Paxil and Cogentin. AR 533.

The ALJ’s Decision

Using the Social Security Administration’s five-step sequential evaluation process, the ALJ 

determined that Plaintiff did not meet the disability standard. AR 9-18. More particularly, the ALJ 

found that Plaintiff had not engaged in any substantial gainful activity since June 30, 2009, his alleged 

onset date. AR 11. Further, the ALJ identified obesity, obstructive sleep apnea, ligament tear of the 

right wrist and depressive disorder as severe impairments. AR 11. Nonetheless, the ALJ determined 

that the severity of Plaintiff’s impairments did not meet or exceed any of the listed impairments. AR 

12-13. Based on his review of the entire record, the ALJ determined that Plaintiff retained the residual 

functional capacity (“RFC”) to lift and carry 20 pounds occasionally, 10 pounds frequently, sit or 

stand and walk for six hours in an eight-hour workday, never climb ladders, ropes, or scaffolds and 

frequently balance, stoop, kneel, crouch, crawl and climb ramps or stairs. He could perform simple 

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repetitive tasks, but must avoid even moderate exposure to fumes, dusts, odors, gases and poor 

ventilation. AR 13-16. The ALJ found that Plaintiff could not perform any of his past relevant work, 

but could perform jobs that exist in significant numbers in the national economy. AR 17-18. The ALJ 

therefore concluded that Plaintiff was not disabled under the Social Security Act. AR 18. 

SCOPE OF REVIEW

Congress has provided a limited scope of judicial review of the Commissioner’s decision to 

deny benefits under the Act. In reviewing findings of fact with respect to such determinations, this 

Court must determine whether the decision of the Commissioner is supported by substantial evidence. 

42 U.S.C. § 405(g). Substantial evidence means “more than a mere scintilla,” Richardson v. Perales, 

402 U.S. 389, 402 (1971), but less than a preponderance. Sorenson v. Weinberger, 514 F.2d 1112, 

1119, n. 10 (9th Cir. 1975). It is “such relevant evidence as a reasonable mind might accept as 

adequate to support a conclusion.” Richardson, 402 U.S. at 401. The record as a whole must be 

considered, weighing both the evidence that supports and the evidence that detracts from the 

Commission’s conclusion. Jones v. Heckler, 760 F.2d 993, 995 (9th Cir. 1985). In weighing the 

evidence and making findings, the Commissioner must apply the proper legal standards. E.g., 

Burkhart v. Bowen, 856 F.2d 1335, 1338 (9th Cir. 1988). This Court must uphold the Commissioner’s 

determination that the claimant is not disabled if the Commissioner applied the proper legal standards, 

and if the Commissioner’s findings are supported by substantial evidence. See Sanchez v. Sec’y of 

Health and Human Serv., 812 F.2d 509, 510 (9th Cir. 1987).

REVIEW

In order to qualify for benefits, a claimant must establish that he or she is unable to engage in 

substantial gainful activity due to a medically determinable physical or mental impairment which 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). A claimant must show that he or she has a physical or mental impairment of such 

severity that he or she is not only unable to do his or her previous work, but cannot, considering his or 

her age, education, and work experience, engage in any other kind of substantial gainful work which 

exists in the national economy. Quang Van Han v. Bowen, 882 F.2d 1453, 1456 (9th Cir. 1989). The 

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burden is on the claimant to establish disability. Terry v. Sullivan, 903 F.2d 1273, 1275 (9th Cir. 

1990).

In his opening brief, Plaintiff contends that the ALJ erred in (1) his RFC assessment, (2) 

evaluating the opinion of Plaintiff’s treating psychiatrist, and (3) evaluating the non-medical source 

statement of Plaintiff’s mother. 

DISCUSSION2

1. The ALJ Properly Determined Plaintiff’s RFC

Plaintiff argues that the ALJ’s RFC assessment failed to fully address Plaintiff’s manipulative 

limitations. RFC 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 of 8 hours a day, for 5 days a 

week, or equivalent work schedule. SSR 96-8p. The RFC assessment considers only functional 

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

combination of impairments. SSR 96-8p. “In determining a claimant’s RFC, an ALJ must consider 

all relevant evidence in the record including, inter alia, medical records, lay evidence, and ‘the effects 

of symptoms, including pain, that are reasonably attributed to a medically determinable impairment.’”

Robbins v. Social Security Admin., 466 F.3d 880, 883 (9th Cir. 2006) (quoting SSR 96-8p).

Plaintiff first contends that the ALJ failed to explain why he rejected the manipulative 

limitations of frequent reaching, handling, fingering and feeling, which were identified by Dr. Rios. 

(Doc. 20 at 10.) In this instance, the Commissioner contends that the ALJ “inadvertently omitted” the 

ability to “frequently reach, handle, finger, and feel” in the RFC determination and the relevant 

hypothetical posed to the VE, but such error was harmless. (Doc. 21 at 16.) 

Contrary to the Commissioner’s assertion, the ALJ’s omission was not inadvertent. As is 

evident from his opinion, the ALJ tacitly rejected these manipulative limitations. In particular, the 

ALJ first considered the 2011 electrophysiological study identifying moderate to severe carpal tunnel 

syndrome in both wrists, along with x-rays revealing tears of the scapholunate ligaments in both 

 

2

The parties are advised that this Court has carefully reviewed and considered all of the briefs, including 

arguments, points and authorities, declarations, and/or exhibits. Any omission of a reference to any specific argument or 

brief is not to be construed that the Court did not consider the argument or brief.

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wrists. AR 14, 424, 426-427. In considering these medical reports, the ALJ noted that they did not 

contain opinions that Plaintiff was disabled (AR 14), nor did they identify any correlating functional 

limitations. AR 14, 424, 426-427. The mere presence of a diagnosis in the record is insufficient to 

establish disability. See Matthews v. Shalala, 10 F.3d 678, 680 (9th Cir. 1993) (mere existence of 

impairment is insufficient proof of a disability; claimant bears the burden of proving that an 

impairment is disabling).

The ALJ next considered the opinion of examining physician, Dr. Rios, who concluded that 

Plaintiff could lift and carry 50 pounds occasionally and 25 pounds frequently and could frequently 

reach, handle, finger and feel. AR 14, 447-451. The ALJ assigned “some limited weight” to Dr. Rios’ 

opinion, but reduced Plaintiff’s lifting and carrying capacity “given his complaints of wrist pain.” AR 

15. This reasoning demonstrates the ALJ’s implicit rejection of other limitations identified by Dr. 

Rios related to the condition of Plaintiff’s wrists, i.e., his restrictions to frequent reaching, handling, 

fingering and feeling. AR 15. 

As Plaintiff admits, Dr. Rios reportedly lacked the benefit of Plaintiff’s EMG and x-rays 

showing carpal tunnel syndrome and tearing of the scapholunate ligaments. (Doc. 20 at 10, 11.) 

However, Plaintiff’s assertion that the ALJ relied on a medical opinion that did not take into account 

objective evidence of carpal tunnel syndrome is incorrect. In this case, the nonexamining state agency 

physician, Dr. Matsuyama, whose opinion the ALJ assigned some weight, had the benefit of Plaintiff’s 

clinical records. In assessing Plaintiff’s RFC, Dr. Matsuyama expressly acknowledged that Plaintiff 

had EMG testing done on both wrists and was diagnosed as having bilateral moderate to severe carpal 

tunnel syndrome. Even with this clinical evidence, Dr. Matsuyama did not identify any manipulative 

limitations. AR 508-515. When the ALJ rejects the opinion of an examining physician in reliance on 

the nonexamining physician, “reports of the nonexamining advisor need not be discounted and may 

serve as substantial evidence when they are supported by other evidence in the record and are 

consistent with it.” Andrews v. Shalala, 53 F.3d 1035, 1041 (9th Cir. 1995); Saelee v. Chater, 94 F.3d 

520, 522 (9th Cir. 1996). Here, Dr. Matsuyama had the benefit of Plaintiff’s clinical findings, but did 

not identify any restrictions on reaching, handling, fingering or feeling. Consistent with Dr. 

Matsuyama’s opinion, the ALJ noted that Dr. Rios found Plaintiff’s wrists to be negative for Tinel’s 

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and Phalen’s signs and his fine and gross finger manipulation was preserved. AR 14-15, 450. The 

ALJ also found that no treating physician had opined that Plaintiff was disabled or that his workrelated abilities were impaired. AR 16. Additionally, the ALJ relied on Plaintiff’s daily activities to 

discount his complaints of disabling symptoms and limitations, which include the ability to do 

housework, wash dishes, do laundry, mow the lawn, care for his own personal hygiene, shop, prepare 

meals and drive. AR 12, 16. 

The Court finds that the ALJ did not err in his physical RFC finding related to manipulative 

limitations. However, even if the ALJ did err in rejecting the manipulative limitations identified by 

Dr. Rios, such error is harmless, as the Commissioner suggests, because the outcome would have been 

the same if those manipulative limitations were included in the RFC and hypotheticals posed to the 

VE. See Parra v. Astrue, 481 F.3d 742, 747 (9th Cir. 2007) (finding error harmless where it would not 

affect the ALJ’s ultimate decision); Stout v. Commissioner, 454 F.3d 1050, 1055 (9th Cir. 2006) (error

harmless if it is nonprejudicial to the claimant or irrelevant to the ALJ’s ultimate disability 

conclusion); Burch v. Barnhart, 400 F.3d 676, 679 (9th Cir. 2005) (“A decision of the ALJ will not be 

reversed for errors that are harmless.”). 

In this case, the ALJ, in a second hypothetical, asked the VE to consider a worker who was

capable of light physical exertion, but could never climb ladders, ropes, or scaffolds, could frequently 

balance, stoop, kneel, crouch, crawl, and climb ramps or stairs, and must avoid even moderate 

exposure to fumes, odors, dusts, gasses, and poor ventilation. The VE testified that such a worker 

could perform other jobs in the economy, such as packing line worker, garment sorter, and ampoule 

filler. AR 49. Of these jobs, both garment sorter and ampoule filler are consistent with the ability to 

frequently reach, handle, finger and feel. According to the Dictionary of Occupational Titles, a 

garment sorter job (DOT No. 222.687-014) requires frequent reaching, frequent handling and 

occasional fingering, but does not involve feeling. Similarly, an ampoule filler job (DOT No. 

559.685-018) requires frequent reaching and frequent handling, but does not involve fingering or 

feeling. Accordingly, even though the ALJ omitted Dr. Rios’ manipulative limitations from the 

second hypothetical, the outcome would have been the same; that is, Plaintiff retained the residual 

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functional capacity, with manipulative limitations, to perform jobs that exist in significant numbers in 

the national economy, such as garment sorter and ampoule filler. AR 17-18. 

2. The ALJ Properly Evaluated the Opinion of Plaintiff’s Treating Psychiatrist

Plaintiff contends that the ALJ improperly evaluated the opinion of Dr. Ensom, Plaintiff’s 

treating psychiatrist. (Doc. 20 at 13-14.) 

Cases in this circuit distinguish among the opinions of three types of physicians: (1) those who 

treat the claimant (treating physicians); (2) those who examine but do not treat the claimant 

(examining physicians); and (3) those who neither examine nor treat the claimant (nonexamining 

physicians). Lester v. Chater, 81 F.3d 821, 830 (9th Cir. 1995). Generally, a treating physician’s 

opinion should be accorded more weight than opinions of doctors who did not treat the claimant, and 

an examining physician’s opinion is entitled to greater weight than a non-examining physician’s 

opinion. Id. Where an examining physician’s opinion is uncontradicted by another doctor, the 

Commissioner must provide “clear and convincing” reasons for rejecting the examining physician’s 

ultimate conclusions. Id. If the examining doctor’s medical opinion is contradicted by another doctor, 

the Commissioner must provide “specific and legitimate” reasons for rejecting that medical opinion, 

and those reasons must be supported by substantial evidence in the record. Id. at 830–31. The ALJ can 

meet this burden by setting forth a detailed and thorough summary of the facts and conflicting clinical 

evidence, stating his interpretation thereof, and making findings. Tommasetti v. Astrue, 533 F.3d 1035, 

1041 (9th Cir. 2008).

Notwithstanding the above discussion, an ALJ is not required to accept an opinion of a 

physician if it is conclusory and not supported by clinical findings. Matney v. Sullivan, 981 F.2d 1016, 

1019 (9th Cir. 1992). Additionally, an ALJ is not bound to a medical source’s opinion concerning a 

claimant’s limitations on the ultimate issue of disability. Magallanes v. Bowen, 881 F.2d 747, 751 (9th 

Cir. 1989). If the record as a whole does not support the medical source’s opinion, the ALJ may reject 

that opinion. Batson v. Comm’r of Soc. Sec. Admin., 359 F.3d 1190, 1195 (9th Cir. 2004). Items in the 

record that may not support the physician’s opinion include clinical findings from examinations, 

conflicting medical opinions, conflicting physician’s treatment notes, and the claimant’s daily 

activities. Id.; Bayliss v. Barnhart, 427 F.3d 1211, 1216 (9th Cir. 2005); Connett v. Barnhart, 340 F.3d 

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871, 874-75 (9th Cir. 2003); Morgan v. Comm’r of Soc. Sec. Admin., 169 F.3d 595, 600-601 (9th Cir. 

1999).

Here, Plaintiff faults the ALJ for failing to credit Dr. Ensom’s assignment of a Global 

Assessment of Functioning (GAF) score of 40. (Doc. 20 at 13.) As Plaintiff suggests, the ALJ did not 

reference Plaintiff’s GAF score of 40, which is derived from the Diagnostic and Statistical Manual of 

Mental Disorders Fourth Edition (“DSM-IV”). Contrary to Plaintiff’s assertion, the ALJ’s mere 

failure to mention the GAF score does not render his assessment of Plaintiff’s mental RFC deficient. 

See Lopez v. Coleman, No. 1:13-cv-00741-SKO, 2014 WL 3362250, *13 (E.D. Cal. Jul. 8, 2014)

(citing Howard v. Comm’r of Soc. Sec., 276 F.3d 235, 241 (6th Cir. 2002)); Osburn v. Colvin, No.

2:12-cv-2875 AC, 2013 WL 6389139, *6 (E.D. Cal. Dec. 6. 2013) (ALJ’s failure to discuss the GAF, 

standing alone, does not render the decision deficient); Chavez v. Astrue, 699 F.Supp.2d 1125, 1135 

(C.D. Cal. 2009). A GAF score is a rough estimate of an individual’s psychological, social and 

occupational functioning used to reflect the individual’s need for treatment, but does not have any 

direct correlative work-related or functional limitations. See Hughes v. Colvin, 599 Fed.Appx. 765, 

766 (9th Cir. 2015) (citing Vargas v. Lambert, 159 F.3d 1161, 1164 n. 2. (9th Cir. 1998)).

Plaintiff also faults the ALJ for failing to explain the weight given to Dr. Ensom’s opinion. 

(Doc. 20 at 14.) In this instance, the ALJ summarized and evaluated Dr. Ensom’s treatment notes, 

stating: 

A Turning Point Rural Clinic psychiatric evaluation of May 30, 2012, by Robert T. 

Ensom, M.D., includes Mr. Navarro’s chief complaint “I always hear voices” (Exhibit 21 

F, p. 5). He noted his last cannabis use was 3 years earlier, and last methamphetamine 

use in 2003 (Exhibit 21 F, p. 5). He was cooperative with appropriate affect and eye 

contact. His mood was depressed and anxious, but his speech and thought processes 

were normal and intact. His memory was intact (Exhibit 21 F, p. 6.) Dr. Ensom 

diagnosed Mr. Navarro with a psychotic disorder, not otherwise specified (Exhibit 21F, p. 

7.) [¶] Medications were prescribed, and on June 13, 2012, Mr. Navarro had a normal 

mental status, but was restless as a side effect (Exhibit 21F, p. 4). Medications were 

changed and on July 11, 2012, Mr. Navarro’s restlessness improved, and auditory 

hallucinations decreased (Exhibit 21 F, p. 2). These records do not contain any opinions 

indicating Mr. Navarro is disabled, but merely report his subjective complaints and 

suggest treatments. 

AR 15. Based on the discussion and analysis, it is apparent that the ALJ assigned limited weight to 

Dr. Ensom’s opinion, which was contradicted by an examining physician. The ALJ provided specific 

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and legitimate reasons for assigning less than controlling weight to Dr. Ensom’s opinion. Amongst 

other reasons, the ALJ discounted Dr. Ensom’s opinion because his treatment notes contained no 

opinion that Plaintiff was disabled. AR 15. The opinion of a treating doctor may be appropriately 

rejected where the treatment notes fail to present “the sort of description and recommendations one 

would expect to accompany a finding that [the claimant] was totally disabled under the [Social 

Security] Act”). Rollins v. Massanari, 261 F.3d 853, 856 (9th Cir. 2001). The ALJ also appropriately

discounted Dr. Ensom’s opinion because treatment notes revealed that with the use of prescription 

medication, Plaintiff’s mental status was normal, his restlessness improved and his hallucinations 

decreased. Odle v. Heckler, 707 F.2d 349, 440 (9th Cir. 1983) (rejecting disability claim where 

claimant’s impairments were responsive to medications). The ALJ assigned some weight to Dr.

Ensom’s opinion, crediting the diagnosis of “psychotic disorder, not otherwise specified” and 

thereafter limiting Plaintiff to simple, routine type work due to his alleged auditory hallucinations and 

social anxiety. AR 16. 

In discounting Dr. Ensom’s opinion, the ALJ also considered the opinion of examining 

physician, Dr. Schmidt. In particular, the ALJ considered Dr. Schmidt’s findings regarding Plaintiff’s 

activities of daily living, Plaintiff’s report that he had not experienced hallucinations for more than a 

year and that, on mental status, Plaintiff was fully oriented and his long, short and working memory 

appeared intact. AR 16, 438-444. Following examination, Dr. Schmidt concluded that Plaintiff’s 

functional level was adequate with no significant mental health impairment and no impairment in any 

area of mental functioning. AR 15-16, 443-444. “[W]hen an examining physician provides 

‘independent clinical findings that differ from the findings of the treating physician,’ such findings are 

‘substantial evidence’”. See Orn v. Astrue, 495 F.3d 625, 632 (9th Cir. 2007). Here, the ALJ assigned 

slight weight to Dr. Schmidt’s conflicting opinion, and, as noted, credited Dr. Ensom’s diagnosis when 

determining Plaintiff’s mental RFC. AR 15-16. There is ample medical evidence in the record to 

support the ALJ’s resolution of the differing opinions between the examining and treating physicians, 

such that his decision is supported by substantial evidence. Key v. Heckler, 754 F.2d 1545, 1549 (9th 

Cir. 1985) (ALJ has the responsibility for resolving conflicts in the record, and a court will not disturb 

an ALJ’s findings if they are supported). 

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3. The ALJ Did Not Commit Reversible Error in Failing to Discuss Lay Witness 

Testimony

Plaintiff contends that the ALJ erred by failing to consider and weigh the written statement of 

Plaintiff’s mother, Patricia Gallardo. (Doc. 20 at 14-15.) The Commissioner counters that while the 

ALJ did not address this third-party statement, any such error was harmless (Doc. 21 at 21.) 

An ALJ must consider lay witness testimony concerning a claimant’s ability to work. Bruce v. 

Astrue, 557 F.3d 1113, 1115 (9th Cir. 2009) (quoting Stout, 278 F.3d at 924); 20 C.F.R. § 

404.1513(d)(4). “Such testimony is competent evidence and cannot be disregarded without 

comment.” Id. (quoting Nguyen v. Chater, 100 F.3d 1462, 1467 (9th Cir. 1996) (emphasis in original). 

If an ALJ disregards testimony from a lay witness, the ALJ must provide specific reasons germane to 

each witness. Id. 

In this instance, the ALJ failed to specifically address the testimony of Ms. Gallardo, who 

provided a third party function report in September 2011. According to Ms. Gallardo, Plaintiff 

prepares meals on a daily basis, watches television, takes care of pets, mows the lawn, does laundry

and shops. He goes outside once or twice a day. When he goes out, he walks, drives a car or rides a 

bicycle. His obesity prevents him from standing for long times and his joints are painful. His 

depression stops him from doing a lot of things, including holding down a job. Plaintiff also uses a 

CPAP machine to help with sleep. Plaintiff has no problem with personal care and does not need 

reminders to take medications or to take care of his personal needs and grooming. Plaintiff does not 

feel good about being around people and thinks that everyone is saying things about him. He does not 

attend social events. Ms. Gallardo believed that Plaintiff could not keep a job due to his physical and 

mental disabilities. She believed Plaintiff’s conditions affected his ability to lift, squat, bend, stand, 

reach, walk, kneel, stair climb, see, complete tasks, concentrate, use his hands and get along with 

others. His obesity made it hard to be physically active and his mental disability made it hard to be 

around people. AR 340-347. 

The Commissioner argues that the ALJ did not commit reversible error by failing to address 

Ms. Gallardo’s statements because the ALJ otherwise addressed Plaintiff’s identical allegations. (Doc. 

21 at 21.) The Court agrees. 

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An ALJ’s failure to address a lay witness’ testimony is harmless if it is inconsequential to the 

ultimate nondisability determination in the context of the record as a whole. Molina v. Astrue, 674 

F.3d 1104, 1122 (9th Cir. 2012); see also Tommasetti, 533 F.3d at 1038; Carmickle v. Comm’r, Soc. 

Sec. Admin, 533 F.3d 1155, 1162 (9th Cir. 2008). That happens when “the same evidence that the ALJ 

referred to in discrediting [the claimant’s] claims also discredits [the lay witness’s] claims.” Molina, 

674 F.3d at 1122 (alterations in original) (quoting Buckner v. Astrue, 646 F.3d 549, 560 (8th Cir. 

2011)). Plaintiff has not challenged the ALJ’s evaluation of his testimony and credibility. 

Here, the Court finds that the ALJ provided clear and convincing reasons for rejecting 

Plaintiff’s testimony, which would support the rejection of Ms. Gallardo’s matching testimony. 

Smolen v. Chater, 80 F.3d 1273, 1284 (9th Cir. 1996); Lester v. Chater, 81 F.3d 821, 834 (9th Cir. 

1996) (as amended). For instance, the ALJ rejected the severity of Plaintiff’s asserted symptoms and 

their alleged effect on function as not entirely consistent with the medical evidence. AR 16. As an 

example, the ALJ relied, in part, on findings of the state agency consultative examiner, Dr. Rios. AR 

15. Dr. Rios noted that Plaintiff was obese, but not any severe distress and was able to get on and off 

the examination table. He walked with a slight limp, but his tandem walk was normal and negative for 

Romberg. His knees revealed crepitation, but no effusion or collapsing weakness. His wrists were 

negative for Tinel’s and Phalen’s signs and his fine and gross finger manipulation was preserved. He 

also had motor strength of 5/5 throughout with normal muscle bulk and tone. Dr. Rios found that 

Plaintiff could stand, sit and walk for up to six hours, could lift and carry 50 pounds occasionally, 25 

pounds frequently, and frequently could climb, balance, stoop, kneel, crouch, crawl, reach, handle, 

finger and feel. AR 447-451. The ALJ reduced Plaintiff’s lifting and carrying capacity, but properly 

relied on the medical evidence in assessing Plaintiff’s credibility. Rollins, 261 F.3d at 857 (“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 the claimant’s pain and its disabling effects”); Burch, 400 F.3d at 681 (“Although lack of medical 

evidence cannot form the sole basis for discounting pain testimony, it is a factor that the ALJ can 

consider in his credibility analysis”). Additionally, the ALJ acknowledged Plaintiff’s response to 

mental health treatment and psychiatric medications. AR 15. When assessing credibility, an ALJ 

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properly may consider a physician’s report of improvement with medication. Morgan v. Comm’r of 

Soc. Sec. Admin., 169 F.3d 595, 599 (9th Cir. 1999).

The ALJ also properly found that Plaintiff had described daily activities which were not 

limited to the extent one would expect, given his complaints of disabling symptoms and limitations. 

AR 16. The ALJ reasoned that Plaintiff’s ability to do housework, tend to all personal needs, shop, 

prepare meals, and drive, all of which were noted by Ms. Gallardo, were inconsistent with an inability 

to perform any kind of work. AR 16. Activities of daily living are a valid consideration when 

evaluating a claimant’s credibility. See Rollins, 261 F.3d at 857 (allegation of disability undermined 

by testimony about daily activities); Valentine v. Comm’r, Soc. Sec. Admin., 574 F.3d 685, 693 (9th 

Cir. 2009) (ALJ properly considered claimant’s activities in rejecting his credibility). Also, the ALJ

found that Plaintiff’s appearance and demeanor while testifying at the hearing were unpersuasive,

noting that Plaintiff was pleasant, cooperative and responsive during the course of his testimony. AR 

12, 16. An ALJ may properly consider a claimant’s demeanor in evaluating a claimant’s credibility. 

SSR 96-7p (“[i]n instances in which the adjudicator has observed the individual, the adjudicator . . . 

should consider any personal observations in the overall evaluation of the credibility of the 

individual’s statements”); Tonapetyan, 242 F.3d at 1148 (ALJ’s credibility determination may be 

based, in part, on his personal observations); Thomas v. Barnhart, 278 F.3d 947, 960 (9th Cir. 2002)

(ALJ may consider demeanor in credibility evaluation). 

CONCLUSION

Based on the foregoing, the Court finds that the ALJ’s decision 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 the Commissioner of Social Security. 

The Clerk of this Court is DIRECTED to enter judgment in favor of Defendant Carolyn W. Colvin, 

Acting Commissioner of Social Security, and against Plaintiff Corry Flores Navarro. 

IT IS SO ORDERED.

Dated: September 11, 2015 /s/ Barbara A. McAuliffe _

UNITED STATES MAGISTRATE JUDGE

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