Document ID: s3://data.kl3m.ai/documents/govinfo/USCOURTS/USCOURTS-caed-1_23-cv-01691/USCOURTS-caed-1_23-cv-01691-1/pdf.json

Parties Involved:
Commissioner of Social Security
Defendant
Ashley Marie Trede
Plaintiff

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UNITED STATES DISTRICT COURT

EASTERN DISTRICT OF CALIFORNIA

ASHLEY MARIE TREDE,

Plaintiff,

v.

COMMISSIONER OF SOCIAL 

SECURITY,

Defendant.

No. 1:23-cv-1691-GSA

ORDER DIRECTING ENTRY OF 

JUDGMENT IN FAVOR OF PLAINTIFF 

AND AGAINST DEFENDANT

(Doc 10, 14)

I. Introduction

Plaintiff Ashley Marie Trede appeals the decision of the Commissioner of Social Security

denying her application for disability insurance benefits (DIB) under Title II of the Social Security 

Act.1 Because substantial evidence and applicable law do not support the ALJ’s decision, the 

appeal will be granted.

II. Factual and Procedural Background

On December 30, 2020, Plaintiff applied for DIB alleging disability as May 1, 2020. The 

applications were denied initially on April 19, 2021, and on reconsideration on January 13, 2022. 

AR 106; 129. The ALJ held a hearing on March 28, 2023. AR 36–69. On May 3, 2023, the ALJ 

issued an unfavorable decision. AR 15–35. The Appeals Council denied review on October 12, 

2023, and this appeal followed. 

III. The Disability Standard

Under 42 U.S.C. §405(g), this court has the authority to review the Commissioner’s denial 

of disability benefits. Reversal is appropriate when the ALJ’s findings are based on legal error or 

unsupported by substantial evidence.” Tackett v. Apfel, 180 F.3d 1094, 1097 (9th Cir. 1999). 

Substantial evidence is that which could lead reasonable minds to accept a conclusion. See 

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

1 The parties consented to the jurisdiction of a United States Magistrate Judge. Docs. 5, 7. 

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

The court must consider the record as a whole, not isolate a specific portion thereof. 

Robbins v. Social Security Admin., 466 F.3d 880, 882 (9th Cir. 2006). If the evidence could 

reasonably support two conclusions, the court “may not substitute its judgment for that of the 

Commissioner” and must affirm the decision. Jamerson v. Chater, 112 F.3d 1064, 1066 (9th Cir. 

1997) (citation omitted). “[T]he court will not reverse an ALJ’s decision for harmless error, which 

exists when it is clear from the record that the ALJ’s error was inconsequential to the ultimate 

nondisability determination.” Tommasetti v. Astrue, 533 F.3d 1035, 1038 (9th Cir. 2008). 

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

he or she is unable to engage in substantial gainful activity due to a medically 

determinable physical or mental impairment that has lasted or can be expected to 

last for a continuous period of not less than twelve months. 42 U.S.C. § 

1382c(a)(3)(A). An individual shall be considered to have a disability only if . . . 

his physical or mental impairment or impairments are of such severity that he is not 

only unable to do his previous work, but cannot, considering his age, education, and 

work experience, engage in any other kind of substantial gainful work which exists 

in the national economy, regardless of whether such work exists in the immediate 

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

he would be hired if he applied for work.

42 U.S.C. §1382c(a)(3)(B).

A disability claim is evaluated using five-step analysis. 20 C.F.R. §§ 416.920(a)-(f). The 

ALJ proceeds through the steps and stops upon reaching a dispositive finding that the claimant is 

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

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

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

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

equivalent to one of the listed impairments set forth in 20 C.F.R. § 404, Subpart P, Appendix 1, (4) 

whether the claimant retained the residual functional capacity (“RFC”) to perform past relevant 

work, and (5) whether the claimant had the ability to perform other jobs existing in significant 

numbers at the national and regional level. 20 C.F.R. § 416.920(a)-(f). While the Plaintiff bears 

the burden of proof at steps one through four, the burden shifts to the commissioner at step five to 

prove that Plaintiff can perform other work in the national economy given her RFC, age, education 

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and work experience. Garrison v. Colvin, 759 F.3d 995, 1011 (9th Cir. 2014).

IV. The ALJ’s Decision

At step one the ALJ found that Plaintiff had not engaged in substantial gainful activity since 

the alleged disability onset date of May 1, 2020. AR 21. At step two the ALJ found that Plaintiff 

had the following severe impairments: psychogenic nonepileptic seizures, bipolar disorder, and 

generalized anxiety disorder. AR 21–22. The ALJ also determined at step two that Plaintiff’s 

gastroesophageal reflux disorder (GERD) and migraine headaches were not severe, and that there 

was insufficient evidence to establish a medically determinable impairment of fibromyalgia. AR 

21–22.

At step three the ALJ found that Plaintiff did not have an impairment or combination thereof 

that met or medically equaled the severity of one of the impairments listed in 20 C.F.R. Part 404, 

Subpart P, Appendix 1. AR 22–24.

Prior to step four the ALJ evaluated Plaintiff’s residual functional capacity (RFC) and 

concluded that Plaintiff had the RFC to perform a full range of work at all exertional levels with 

the following non-exertional limitations:

no climbing of ladders, ropes, or scaffolds; avoid all exposure to unprotected 

heights; simple, routine tasks with only occasional interaction with the public and 

occasional interaction with coworkers.

AR 24–28.

At step four the ALJ concluded that Plaintiff could not perform her past relevant work as a 

receptionist. AR 28. At step five, in reliance on the VE’s testimony, the ALJ concluded that there 

were jobs existing in significant numbers in the national economy which Plaintiff could perform:

merchandise marker and routing clerk. AR 29. Accordingly, the ALJ concluded that Plaintiff was 

not disabled at any time since the alleged disability onset date of May 1, 2020. AR 29.

V. Issues Presented

Plaintiff asserts that the ALJ failed to properly evaluate the medical opinions and that the 

ALJ failed to provide clear and convincing reasons for discounting Plaintiff’s subjective allegations 

of mental dysfunction. 

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A. RFC Generally; The Medical Opinions

1. Applicable Law

Before proceeding to step four, the ALJ must first determine the claimant’s residual 

functional capacity. Nowden v. Berryhill, No. EDCV 17-00584-JEM, 2018 WL 1155971, at *2 

(C.D. Cal. Mar. 2, 2018). The RFC is “the most [one] can still do despite [his or her] limitations” 

and represents an assessment “based on all the relevant evidence.” 20 C.F.R. §§ 404.1545(a)(1), 

416.945(a)(1). The RFC must consider all of the claimant’s impairments, including those that are 

not severe. 20 C.F.R. §§ 416.920(e), 416.945(a)(2); Social Security Ruling (“SSR”) 96–8p.

In doing so, the ALJ must determine credibility, resolve conflicts in medical testimony and 

resolve evidentiary ambiguities. Andrews v. Shalala, 53 F.3d 1035, 1039–40 (9th Cir. 1995). “In 

determining a claimant’s RFC, an ALJ must consider all relevant evidence in the record such as 

medical records, lay evidence and the effects of symptoms, including pain, that are reasonably 

attributed to a medically determinable impairment.” Robbins, 466 F.3d at 883. See also 20 C.F.R. 

§ 404.1545(a)(3) (residual functional capacity determined based on all relevant medical and other 

evidence). “The ALJ can meet this burden by setting out a detailed and thorough summary of the 

facts and conflicting evidence, stating his interpretation thereof, and making findings.” Magallanes 

v. Bowen, 881 F.2d 747, 751 (9th Cir. 1989).

For applications filed on or after March 27, 2017, the new regulations eliminate a hierarchy 

of medical opinions, and provide that “[w]e will not defer or give any specific evidentiary weight, 

including controlling weight, to any medical opinion(s) or prior administrative medical finding(s), 

including those from your medical sources.” 20 C.F.R. § 404.1520c(a). Rather, when evaluating 

any medical opinion, the regulations provide that the ALJ will consider the factors of supportability, 

consistency, treatment relationship, specialization, and other factors. 20 C.F.R. § 404.1520c(c). 

Supportability and consistency are the two most important factors and the agency will 

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articulate how the factors of supportability and consistency are considered. Id. “Even under the 

new regulations, an ALJ cannot reject an examining or treating doctor's opinion as unsupported or 

inconsistent without providing an explanation supported by substantial evidence.” Woods v. 

Kijakazi, 2022 WL 1195334, (9th Cir. Apr. 22, 2022) at *6.

With respect to “supportability,” the new regulations provide that “[t]he more relevant the 

objective medical evidence and supporting explanations presented by a medical source are to 

support his or her medical opinion(s) or prior administrative medical finding(s), the more 

persuasive the medical opinions or prior administrative medical finding(s) will be.” 20 C.F.R. § 

416.920c(c)(1). Regarding “consistency,” the regulations provide that “[t]he more consistent a 

medical opinion(s) or prior administrative medical finding(s) is with the evidence from other 

medical sources and nonmedical sources in the claim, the more persuasive the medical opinion(s) 

or prior administrative medical finding(s) will be.” 20 C.F.R. § 416.920c(c)(2).

2. Analysis

On December 29, 2021, Dr. Faurbo conducted a consultative examination at the request of 

the agency. Dr. Faurbo opined that Plaintiff had marked limitations in her ability to: understand, 

remember, and perform complex instructions; complete a normal workday and workweek without 

interruptions from a psychiatric condition; and deal with the usual stressors encountered in a 

competitive work environment. AR 486. Dr. Faurbo opined that Plaintiff had moderate limitations 

in her ability to: understand, remember, and perform simple instructions; maintain regular 

attendance; perform work activities on a consistent basis; perform work activities without special 

or additional supervision; accept instructions from supervisors; to interact with coworkers and the 

public. AR 486. Dr. Faurbo opined that all limitations were “due to cognitive and functional 

deficits associated with a mood disorder.” Id.

On March 25, 2021, Plaintiff’s treating psychiatrist Dr. Manuel completed a “Short Form 

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Evaluation For Mental Disorders.” Dr. Manuel noted the treatment relationship started in August 

of 2020, identified diagnoses of bipolar 1, depression, generalized anxiety disorder, and personality 

disorder not otherwise specified. AR 458. Dr. Manuel opined that Plaintiff’s functioning was 

“poor2” in the following areas: understand, remember, and carry out complex instructions; maintain 

concentration, attention, and persistence; perform activities within a schedule and maintain regular 

attendance; complete a normal workday and workweek without interruptions from psychologically 

based symptoms; and respond appropriately to changes in a work setting. AR 461. Dr. Manuel 

opined that Plaintiff’s functioning was “fair”3in two areas: understand, remember, and carry out 

simple instructions; interact appropriately with the public, supervisors, and co-workers. Id.

The non-examining consultants, Drs. Schwartz and Aquino-Caro, reviewed Plaintiff’s 

medical file at the initial and reconsideration levels, respectively, and opined in relevant part that 

Plaintiff could sustain attention and concentration for short simple instructions with limited public 

contact, and that she was moderately limited in her ability to respond appropriately to work-place 

changes. AR 100–02; 123–24. 

a. Social Interaction; Performing Work Activities Consistently

To begin, there is no dispute that Plaintiff has at least moderate limitations in her ability to 

interact with others. Indeed, the ALJ did not conclude otherwise and specifically found that this 

particular part of Dr. Faurbo’s opinion and Dr. Manuel’s opinion were supported by findings of 

limited eye contact, anxious mood, social anxiety, pressured speech, and tired appearance. AR 27. 

However, the RFC only provided a limitation to occasional interaction with coworkers and the 

public, but not to occasional interaction with supervisors. This court has previously held that the 

former limitations do not subsume the latter, and that evidence supporting the former also supports

2 The form defined “poor” as “the individual cannot usefully perform or sustain the activity.” AR 461. 

3 The form defined “fair” as “the individual’s capacity to perform the activity is impaired, but the degree/extent of the 

impairment needs to be further described.” Id.

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the latter. See Leal v. O'Malley, No. 1:22-CV-0759 JLT GSA, 2024 WL 1304921, at *4 (E.D. Cal. 

Mar. 27, 2024) (finding the ALJ harmfully erred in adopting the consultant’s opinion as to limited 

ability to interact with coworkers and the public, but omitting without explanation any limitation 

regarding supervisor interaction). 

Here, the ALJ did make some attempt to explain the omission, stating, “a limitation 

regarding interacting with supervisors is inconsistent with cooperative or friendly behavior during 

examinations.” AR 27. However, the explanation is not persuasive as Plaintiff’s social anxiety 

limits her ability to interact with others in the workplace. Moreover, Plaintiff’s interactions with 

her treating providers is not analogous to her interactions with others in the workplace. It seems 

logical to infer that interactions with supervisors are just as anxiety inducing as interactions with 

peers and the public, if not more so. Unsurprisingly, where a claimant has social interaction 

limitations, restrictions on peer interaction, public interaction and supervisor interaction are rarely 

if ever listed in the RFC in isolation. The three nearly always go hand in hand and there appears to 

be no reason why that should not hold true here.

Plaintiff emphasizes the ALJs finding that the same evidence supporting social interaction 

limitations—anxious mood, pressured speech, and tired appearance—also support Dr. Faurbo’s 

opinion that Plaintiff was moderately limited in her ability to perform work activities on a consistent 

basis. MSJ at 7, Doc. 10 (citing AR 27). Plaintiff explains that “in Shaibi v. Berryhill, the Ninth 

Circuit found that a restriction to occasional interaction with coworkers was consistent with a 

medical source’s opinion that the claimant had ‘moderate’ social limitations.” Id. (citing Shaibi v. 

Berryhill, 883 F.3d 1102, 1107 (9th Cir. 2017). Thus, Plaintiff reasons, “It follows that Plaintiff’s 

unrefuted moderate limitations in her ability to perform work activities on a consistent basis would 

require Plaintiff to be off task occasionally.” Id. However, this inferential leap is not justified. 

The fact that the Ninth Circuit found “occasional” co-worker interactions to be a sufficient

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encapsulation of “moderate” social limitations does not mean it was a necessary encapsulation of 

moderate social limitations. Nor does it follow that any moderate limitation in work-related 

functioning necessarily means that the work activity in question can be performed no more than 

occasionally. Simply put, Plaintiff surmises from Shaibi that “moderately limited” is synonymous 

with “no more than occasional,” as that term is defined in SSR 83-10, namely 1/3 of an 8-hour day. 

That conclusion does not follow from the Shaibi opinion or from any other authority. 

Plaintiff further emphasizes the VE’s testimony that 10% or more off-task behavior would 

be work-preclusive (AR 65). However, Plaintiff provides no authority suggesting that a “moderate” 

limitation in the ability to perform work consistently (a qualitative description) necessarily implies 

10% off-task behavior (a quantitative description). Further, if Plaintiff were correct, that would 

mean that a “moderate” limitation is per se disabling, which tends to go against common sense and 

which some courts in this circuit have specifically refuted. See, e.g. McLain v. Astrue, 2011 WL 

2174895, *6 (C.D. Cal. 2011) (“[m]oderate mental functional limitations . . . are not per se 

disabling, nor do they preclude the performance of jobs that involve simple, repetitive tasks”); Rose 

M. E. v. Saul, 2021 WL 1612091, at *3 (C.D. Cal. Apr. 26, 2021) (SSA defines a ‘moderate’ 

limitation to mean ‘[t]here is more than a slight limitation in this area, but the individual can still 

function satisfactorily.’”) (citing HALLEX (Hearings Appeals and Litigation Law Manual) I-2-5-

20, referencing Form HA-1152-U3 (Medical Source Statement of Ability to do Work-related 

Activities (Mental)).

b. Stress Tolerance; Responding to Workplace Changes

Dr. Faurbo opined that Plaintiff was markedly limited in her ability to “deal with the usual 

stresses encountered in a competitive work environment,” (AR 486) and Dr. Manuel opined that 

Plaintiff had a poor ability to “respond appropriately to changes in a work setting” (AR 461). 

Plaintiff contends the ALJ failed to incorporate these limitations into the RFC.

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Although a limitation to simple and repetitive tasks (or similar verbiage) is not a catchall 

accommodation for all mental limitations, it is notable that “district courts throughout the Circuit 

have [] concluded a claimant's low tolerance for stress or moderate limitations in dealing with 

changes are encompassed in a residual functional capacity of simple, repetitive tasks.” Henry v. 

Colvin, No. 1:15-CV-00100-JLT, 2016 WL 164956, at *18 (E.D. Cal. Jan. 14, 2016) (collecting 

cases). Similarly, this court has held that a “moderate to marked” limitation or a “poor” ability in 

these respects is equally accommodated by an RFC for simple and routine tasks. Pullen v. Kijakazi, 

No. 121CV00404ADAHBK, 2023 WL 373380, at *4 (E.D. Cal. Jan. 24, 2023), report and 

recommendation adopted sub nom. Pullen v. Comm'r of Soc. Sec., No. 121CV00404ADAHBK, 

2023 WL 2655808 (E.D. Cal. Mar. 27, 2023).

Here, the limitation in question was identified as “marked,” not “moderate to marked.” 

Nevertheless, absent any authority suggesting how to better accommodate such limitations, the 

above referenced caselaw strongly suggests the RFC here adequately accommodated limitations in 

stress tolerance and adaption to changing work environments. 

c. Completing a Normal Workday/Workweek Without

Interruptions from Psychological Symptoms

As noted above, Dr. Faurbo opined that Plaintiff was markedly limited in her ability to 

complete a normal workday and workweek without interruptions from psychologically based 

symptoms. AR 486. Similarly, Dr. Manuel opined that Plaintiff’s ability to do so was “poor”,

which the form defined as “the individual cannot usefully perform or sustain the activity.” AR 461. 

In that sense, a “poor” ability to perform the activity in question is tantamount to a “marked” (if 

not extreme) limitation in the activity in question. 

With respect to Dr. Faurbo, the ALJ explained that the opinion of Dr. Faurbo was partially 

persuasive (B8F/6), but that her opinion of marked limitations was not supported by her findings 

of good grooming, intact judgment, or insight judgment (B8F/5). AR 27 (citing AR 485). This

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discussion falls well short of what the Ninth Circuit requires. Although no deference is owed to 

any opinion (examining or otherwise) under the revised regulations, and the judicially created

heightened standard of articulation no longer applies, the ALJ still must provide an explanation 

supported by substantial evidence as to how the factors of supportability and consistency were 

considered when evaluating medical opinion evidence from any source. Woods v. Kijakazi, 2022 

WL 1195334, (9th Cir. Apr. 22, 2022) at *6.

The ALJ references generally that Dr. Faurbo “opined to marked limitations,” but the ALJ 

neglected to recite the marked limitations in question, though there were only two. The ALJ then 

references “good grooming” as a countervailing finding undermining Dr. Faurbo’s opinion, though 

it is far from clear how good grooming translates to work-related functioning. The ALJ then makes 

an apparent typographical error, referencing “intact judgment, and insight judgment” (emphasis 

added) though the latter finding was “intact insight,” not “insight judgment.” 

Typos aside, this is not a case where indiscriminate reliance on “mixed clinical findings” 

will justify affirmance. Nor is it persuasive for the Commissioner to rely on the common refrain 

that affirmance is appropriate “if the evidence could reasonably support two conclusions.” 

Jamerson v. Chater, 112 F.3d 1064, 1066 (9th Cir. 1997) (citation omitted). 

Here, Plaintiff had a brief but tumultuous mental health history, including being diagnosed 

with a mood disorder (bipolar 1), medicated with mood stabilizers and anti-psychotics, hospitalized 

for psychogenic seizures, including 6 such seizures corroborated by her family, an additional 

seizure in the presence of hospital personnel, and reportedly another seizure the day before the 

hearing. AR 618, 624, 640, 657. She presented variously with anxious mood, panicked mood, 

depressed mood, tired mood, irritable mood, frustrated mood, helpless/hopeless thought content, 

flat affect and impaired insight and judgment (AR 451, 491, 493, 496, 498, 500, 502, 504, 506, 

508, 510, 512, 514, 522-523), though at times she did present with fairly benign findings as the 

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ALJ indicated. 

Notably, the marked limitations in question were identified not only by the Plaintiff’s 

treating psychiatrist, Dr. Manuel, but also by the independent consultative examiner retained by the 

agency, Dr. Faurbo. As to the marked limitations identified by both examining sources, the 

evidence in support thereof significantly outweighs the mixed clinical findings relied upon by the 

ALJ, and remand is appropriate for reconsideration of this opinion evidence.

B. Subjective Symptomology 

1. Applicable Law

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

subjective pain or symptoms is credible. See Garrison v. Colvin, 759 F.3d 995, 1014 (9th Cir. 

2014); Smolen, 80 F.3d at 1281; S.S.R 16-3p at 3. First, the claimant must produce objective 

medical evidence of an impairment that could reasonably be expected to produce some degree of 

the symptom or pain alleged. Garrison, 759 F.3d at 1014; Smolen, 80 F.3d at 1281–82. If the 

claimant satisfies the first step and there is no evidence of malingering, the ALJ must “evaluate the 

intensity and persistence of [the claimant’s] symptoms to determine the extent to which the 

symptoms limit an individual’s ability to perform work-related activities.” S.S.R. 16-3p at 2. 

An ALJ’s evaluation of a claimant’s testimony must be supported by specific, clear and 

convincing reasons. Burrell v. Colvin, 775 F.3d 1133, 1136 (9th Cir. 2014); see also S.S.R. 16-3p 

at *10. Subjective testimony “cannot be rejected on the sole ground that it is not fully corroborated 

by objective medical evidence,” but the medical evidence “is still a relevant factor in determining 

the severity of claimant’s pain and its disabling effects.” Rollins v. Massanari, 261 F.3d 853, 857 

(9th Cir. 2001); S.S.R. 16-3p (citing 20 C.F.R. § 404.1529(c)(2)). 

As the Ninth Circuit recently clarified in Ferguson, although an ALJ may use “inconsistent

objective medical evidence in the record to discount subjective symptom testimony,” the ALJ 

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“cannot effectively render a claimant's subjective symptom testimony superfluous by demanding 

positive objective medical evidence fully corroborating every allegation within the subjective 

testimony.” Ferguson v. O'Malley, 95 F.4th 1194, 1200 (9th Cir. 2024) (emphasis in original).

In addition to the objective evidence, the other factors considered are: 1) daily activities; 2) 

the location, duration, frequency, and intensity of pain or other symptoms; 3) precipitating and 

aggravating factors; 4) the type, dosage, effectiveness, and side effects of any medication; 5) 

treatment other than medication; 6) other measures the claimant uses to relieve pain or other 

symptom; and 7)) other factors concerning the claimant’s functional limitations and restrictions due 

to pain or other symptoms. 20 C.F.R. § 416.929(c)(3).

2. Analysis

The ALJ relied on much of the same reasoning for rejecting Plaintiff’s testimony as he did 

for rejecting the examining opinions. The discussion was deficient for the same reasons explained 

above. This section will address novel components of the ALJ’s discussion as it relates to Plaintiff’s 

testimony.

The ALJ summarized the testimony as follows:

The claimant alleges her impairments affect her ability to lift, bend, stand, sit,4

talk, remember, complete tasks, concentrate, and get along with others (B4E/6). 

At the hearing, she testified she last experienced a seizure the day prior to the 

hearing. She described feeling dizzy and numb, falling to the ground, blacking out, 

and having a headache after the episode. Prior to this episode, she testified that her 

last seizure was in March of 2022. The claimant also testified that her neurologist 

informed her anxiety could be the cause of these seizures, and she was told by a 

doctor that she could not drive due to these seizures. The claimant further testified 

that she stopped working because she had a mental breakdown where she 

experienced crying, anger, stress, agitation, suicidal thoughts, and difficulty 

focusing. She also endorsed mood swings, depression, anxiety, bipolar tendencies, 

and periods of confusion. The claimant testified that her mental health symptoms 

have worsened, and on a bad day she has difficult time finishing a simple task or 

finishing what she is doing. Additionally, she testified that she has difficulty 

leaving the house due to anxiety. AR 24–25.

4 Plaintiff does not challenge any of the ALJ’s findings or conclusions with respect to her physical impairments. 

Thus, this information is included solely for completeness and background. 

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a. Objective Evidence

The ALJ found Plaintiff’s testimony inconsistent with the objective medical evidence

overall, specifically drawing attention to full orientation and normal cognition despite complaints 

of disorientation (B9F/12, 16, 18, 22); intact memory, attention, and concentration with adequate 

fund of knowledge despite complaints of memory and attention deficits (8F/5; B11F/67). 

On the other hand, the ALJ conceded that, consistent with reports of worsening stress, 

anxiety and depression around the alleged onset date, Plaintiff was objectively found to have a tired 

and lethargic appearance, anxious and irritable mood, dysphoric and flat affect, and helpless or 

hopeless thought content (B9F/34). 

The ALJ further conceded—consistent with Plaintiff’s continued reports to her clinicians 

since the alleged onset date of mood swings, poor sleep, difficulty concentrating, rage, and panic 

attacks (B2F/1; B8F/3 B9F/22, 30)—that Plaintiff’s mental status examinations show depressed 

and/or anxious mood (B2F/3; B8F/5; B9F/6, 8, 10, 12, 18, 16, 20, 22), pressured speech, tired 

appearance, distracted concentration, and limited eye contact (B8F/5; B9F/26, 30). The ALJ 

further acknowledged that in April of 2022, the claimant presented to the hospital and reported 

episodes of seizure activity (B11F/7), that her family reported six such episodes, and that another 

episode occurred in the presence of hospital personnel. Although brain imaging and 

electroencephalogram testing was largely negative, the clinicians concluded the episodes were 

likely psychogenic nonepileptic seizures (B11F/6, 78). 

Thus, the objective evidence did in significant part support, rather than detract from, 

Plaintiff’s alleged symptoms. Here, the ALJ’s suggestion to the contrary is difficult to square with 

the ALJ’s own discussion of the objective evidence in question, objective evidence which in any 

case would not be a sufficient standalone reason to reject Plaintiff’s testimony. See Ferguson v. 

O'Malley, 95 F.4th 1194, 1200 (9th Cir. 2024) (explaining that although an ALJ may use 

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“inconsistent objective medical evidence in the record to discount subjective symptom testimony,” 

the ALJ “cannot effectively render a claimant's subjective symptom testimony superfluous by 

demanding positive objective medical evidence fully corroborating every allegation within the 

subjective testimony.” (emphasis in original)).

b. Other Considerations

The ALJ noted Plaintiff had improved with treatment, specifically citing an October 2020 

treatment note. AR 26 (citing AR 452). The treatment note states “Compared to 2 years ago since 

last update, there has been improvement - moods have been more stable and is less impulsive. 

Currently still continues with difficulty sleeping and anxiety/panic attacks.” AR 452. Improvement 

is a relative term, and the baseline against which the improvement was measured here was 2 years 

earlier, which was almost 18 months prior to the alleged onset date, a time period about which we 

have little information and which is of limited relevance. Further, the treatment note indicates 

continued difficulties with sleep and panic attacks. Id.

The ALJ further cited evidence of improvement from April 2021 to December 2021. Under 

“Assessment,” the treatment note reflects “Response to Medication and Lab Results: Improved.” 

AR 494. The word “improved” in isolation has minimal evidentiary value, particularly given 

additional contextual information at the bottom of the same page: “Client is unable to complete 

daily tasks or function at baseline level without mental health services due to the severity of mental 

health symptoms.” Id.

The ALJ further explained that “the claimant indicated she does not need help preparing 

meals, she reads for three hours per day, and she takes care of three kids (B5F/2; B8F/3; B9F/18)”. 

Importantly, statements from the internal medicine consultative examination should be viewed in 

context as addressing physical, not mental impediments. Further, to the extent the ALJ’s intention 

was to convey that Plaintiff is independent with activities of daily living, the same cited records 

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reflect other statements painting a different picture, including that she lives with her mother and 

kids who do the cooking and household chores. AR 467.

Finally, the ALJ provided additional commentary which warrants no discussion, including:

“treatment record indicates the claimant uses cannabis, which further detracts from the probative 

value of the claimant’s allegations (B9F/33; B13F/26).” AR 26. 

In sum, the ALJ’s reasoning for rejecting Plaintiff’s symptom testimony was not clear or 

convincing.

VI. Conclusion

Remand is appropriate for the ALJ to conduct a new hearing, develop the record as 

necessary, re-evaluate the opinions of Drs. Faurbo and Manuel on the subjects discussed above, 

and Plaintiff’s testimony concerning the same.

VII. Order

For the reasons stated above, substantial evidence and applicable law do not support the 

ALJ’s conclusion that Plaintiff was not disabled. Accordingly, it is ordered that:

1. Plaintiff’s motion for summary judgment (Doc. 10) is GRANTED

2. Defendant’s cross motion (Doc. 14) is DENIED

3. The Commissioner’s decision is reversed and this matter is remanded to the 

Commissioner pursuant to sentence four of 42 U.S.C. § 405(g) for further 

proceedings consistent with this opinion. 

4. The Clerk of Court is directed to enter judgment in favor of Plaintiff Ashley 

Marie Trede and against Defendant Commissioner of Social Security. 

IT IS SO ORDERED.

Dated: November 20, 2024 /s/ Gary S. Austin 

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 UNITED STATES MAGISTRATE JUDGE

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