Court Opinion

ID: 9954530
Source: CourtListenerOpinion
Date Created: 2024-03-26 16:00:58.663868+00
Date Added: 2024-06-11T08:11:55.614256
License: Public Domain

FOR PUBLICATION

      UNITED STATES COURT OF APPEALS
           FOR THE NINTH CIRCUIT

ROBERT CONWAY,                                   No. 22-35427

                 Plaintiff-Appellant,          D.C. No.3:21-cv-
     v.                                           00712-HZ

MARTIN J. O’MALLEY,
Commissioner of Social Security,                   OPINION

                 Defendant-Appellee.

         Appeal from the United States District Court
                  for the District of Oregon
      Marco A. Hernandez, Chief District Judge, Presiding

             Argued and Submitted April 19, 2023
                      Portland, Oregon

                     Filed March 26, 2024

    Before: Johnnie B. Rawlinson and Jennifer Sung, Circuit
         Judges, and Brian M. Morris, * District Judge.

                  Opinion by Judge Sung;
                 Dissent by Judge Rawlinson

*
 The Honorable Brian M. Morris, United States District Judge for the
District of Montana, sitting by designation.
2                      CONWAY V. O’MALLEY

                          SUMMARY **

                         Social Security

    The panel reversed the district court’s judgment
upholding the denial of social security benefits by an
administrative law judge (“ALJ”), and remanded with the
instruction that the district court remand to the agency for
further proceedings.
    The ALJ found that claimant had the residual functional
capacity to perform “medium work” as defined in 20 C.F.R.
404.1576(c) with some limitations. At step five of the
disability determination analysis, the ALJ—relying solely
on the vocational expert’s testimony—found that claimant
could perform other work that existed in significant numbers
in the national economy, and accordingly, denied disability
benefits.
    Pursuant to Terry v. Saul, 998 F.3d 1010, 1014 (9th Cir.
2021), the panel presumed that the vocational expert was
aware of the definition of the term “medium work,” and that
the ALJ and the expert would have shared an understanding
that the term “medium work” implied a six-hour standing
and walking limitation.
    Claimant alleged that the Terry presumption was
rebutted on cross-examination of the expert. The panel held
that the presumption was rebuttable, and that the
presumption was rebutted in this case. The expert’s
significantly different responses to the ALJ’s and counsel’s

**
  This summary constitutes no part of the opinion of the court. It has
been prepared by court staff for the convenience of the reader.
                    CONWAY V. O’MALLEY                     3

questions revealed that the expert did not understand the
ALJ’s hypothetical to impliedly include a six-hour standing
and walking limitation. Because of this, the expert’s
response to the ALJ’s question had no evidentiary value to
support the ALJ’s finding that the plaintiff can perform jobs
in the national economy. The error was not harmless
because the expert’s testimony compels the finding that there
are not enough jobs in the medium work range that claimant
can perform. Consequently, the panel remanded to the
Commissioner of Social Security so that an ALJ can further
develop the record and make specific findings on whether
claimant had transferable work skills.
    Judge Rawlinson dissented because the majority opinion
does not adhere to the substantial evidence standard of
review and fails to give proper deference to the ALJ’s
decision. She would hold that the ALJ’s decision was
supported by substantial evidence.

                        COUNSEL

Paul M. Warren (argued) and Kevin Kerr, Kerr Robichaux
& Carroll, Portland, Oregon, for Plaintiff-Appellant.
Sarah E. Moum (argued), General Attorney; Matthew Pile,
Associate General Counsel; Office of the General Counsel,
Office of Program Litigation, Social Security
Administration, Baltimore, Maryland; Renata A. Gowie,
Civil Division Chief; Kevin C. Danielson, Assistant United
States Attorney; Natalie K. Wight, United States Attorney;
United States Department of Justice, United States
Attorney’s Office, Portland, Oregon; for Defendant-
Appellee.
4                   CONWAY V. O’MALLEY

                        OPINION

SUNG, Circuit Judge:

    Claimant Robert Conway appeals the district court’s
judgment upholding the denial of social security benefits by
an administrative law judge (“ALJ”). Reviewing de novo the
district court’s decision, Leach v. Kijakazi, 70 F.4th 1251,
1254 (9th Cir. 2023), we reverse. The vocational expert’s
testimony does not support the ALJ’s finding that work
Conway could perform exists in significant numbers in the
national economy. Because the ALJ relied on the vocational
expert’s testimony in concluding that Conway was not
disabled, we remand with the instruction that the district
court remand the case to the agency for further proceedings.
          Factual and Procedural Background
    Conway applied for disability benefits in 2017. A state
disability determination service initially evaluated
Conway’s claim. State agency physicians Dr. Berner and Dr.
Johnson each completed a “physical residual functional
capacity assessment” for Conway. That assessment asks the
physician to “rate the individual’s exertional limitations.”
Both Dr. Berner and Dr. Johnson found that Conway has an
exertional limitation of “Stand[ing] and/or walk[ing] (with
normal breaks) for a total of: About 6 hours in an 8-hour
workday.” The state service determined that Conway was
not disabled.
   Conway disagreed with that determination and requested
a hearing before an ALJ. At his hearing, the ALJ called a
vocational expert to testify and asked whether there was
“any medium work” for a hypothetical person of Conway’s
“age, education, and past work experience, who’s limited to
                        CONWAY V. O’MALLEY                             5

medium work, SVP [Specific Vocational Preparation] 2,
entry level work.” The vocational expert responded that
there would be such work and provided “three sample
occupations”: hospital housekeeper, laundry worker, and
dishwasher.
    On cross-examination, Conway’s counsel asked the
vocational expert, “if someone’s only able to be on their feet
for six out of eight hours, maximum, would they be able to
do any medium work or the jobs you listed?” The expert
responded, “The three sample occupations would not
comport with that additional work restriction and [sic] would
be difficult for me to provide substitute unskilled, medium
occupations where a worker would be capped at being on
their feet no more than six hours in a workday.”
     After the hearing, the ALJ denied Conway’s application
for benefits in a written opinion, which follows the well-
established five-step disability determination analysis. See
20 C.F.R. § 416.920(a)(4). The ALJ found that Conway has
two severe impairments: degenerative disease of the lumbar
spine and bipolar affective disorder. The ALJ found Dr.
Berner’s and Dr. Johnson’s assessments to be persuasive and
supported by the record. The ALJ also found that Conway
has the residual functional capacity (“RFC”) to perform
“medium work as defined in 20 CFR 404.1576(c) except he
is limited to simple routine tasks and entry level jobs with a
specific vocational preparation level of two.” 1 At step four,
the ALJ found that Conway could not perform his past work
as a pipefitter. But at step five, the ALJ—relying solely on

1
  An RFC is “the most [one] can still do despite [one’s] limitations.” 20
C.F.R. § 416.945(a)(1). The RFC is used at step four to determine if a
claimant can do past relevant work and at step five to determine if a
claimant can adjust to other work. 20 C.F.R. § 416.920(e).
6                    CONWAY V. O’MALLEY

the vocational expert’s testimony—found that Conway
could perform other work that exists in significant numbers
in the national economy. Accordingly, the ALJ denied
disability benefits.
    The Appeals Council denied Conway’s appeal. Conway
then filed this action. The district court granted judgment to
the Acting Commissioner of the Social Security
Administration (“Commissioner”). Conway timely appeals.
                         Discussion
    The issue presented is whether the ALJ’s finding at step
five—that there is work Conway could perform that exists in
significant numbers in the national economy—is supported
by substantial evidence. For the following reasons, we
conclude that it is not.
    If the ALJ reaches the final step of the five-step process,
the ALJ may rely on a vocational expert’s testimony to find
that there are jobs that the claimant can perform and that
there are enough of those jobs in the national economy.
Leach, 70 F.4th at 1254. Typically, the ALJ questions the
vocational expert by describing a hypothetical person with
the claimant’s limitations. When a claimant challenges the
ALJ’s reliance on the expert’s testimony, as Conway does
here, we must determine whether the ALJ’s hypothetical
accurately described all of the claimant’s limitations. Id. at
1255. “If an ALJ’s hypothetical does not reflect all of the
claimant’s limitations, then the expert’s testimony has no
evidentiary value to support a finding that the claimant can
perform jobs in the national economy.” Id. (cleaned up). “In
that situation, the vocational expert’s testimony cannot
constitute substantial evidence to support the ALJ’s
findings.” Id. (cleaned up).
                     CONWAY V. O’MALLEY                       7

    In this case, the parties agree on the following points:
The ALJ generally credited Dr. Berner’s and Dr. Johnson’s
opinions, and both doctors found that Conway’s exertional
limitations include a limitation of standing and/or walking
“for a total of: About 6 hours in an 8-hour workday.” The
ALJ’s hypothetical was not accurate if it did not include that
six-hour standing/walking limitation. The ALJ’s
hypothetical did not expressly include that limitation.
Rather, the ALJ asked about a hypothetical person “who’s
limited to medium work, SVP 2, entry level work.”
    The Commissioner argues that the hypothetical’s
reference to “medium work” impliedly incorporated the six-
hour standing/walking limitation. In Terry, we considered a
hypothetical that similarly used the term “medium work,”
and we held that a vocational expert “is presumptively aware
of the agency’s well-established definition of this term of
art.” Terry v. Saul, 998 F.3d 1010, 1011 (9th Cir. 2021). The
agency’s regulations define medium work as lifting no more
than 50 pounds at a time with frequent lifting or carrying of
objects weighing up to 25 pounds. 20 C.F.R. § 404.1567(c).
Although the regulation “does not include any express
standing and walking limitation,” in a 1983 published Social
Security Ruling, “the Commissioner interpreted ‘medium
work’ to ‘require[] standing or walking, off and on, for a total
of approximately 6 hours in an 8-hour workday in order to
meet the requirements of frequent lifting or carrying objects
weighing up to 25 pounds.’” Terry, 998 F.3d at 1013
(quoting SSR 83-10, 1983 WL 31251, at *6 (Jan. 1, 1983)).
    Conway concedes that, under Terry, we presume that the
vocational expert was aware of the definition of the term
“medium work,” and therefore, we also presume that “the
ALJ and the expert would have shared an understanding that
the term ‘medium work’ implies a six-hour standing and
8                   CONWAY V. O’MALLEY

walking limitation.” 998 F.3d at 1014. Conway, however,
contends that this presumption was rebutted on cross-
examination.
    First, we consider whether the presumption established
in Terry is rebuttable. We did not consider this issue in
Terry, because Terry made no attempt to rebut the
presumption. 998 F.3d at 1013 (“Terry’s counsel did not
object to the expert’s qualifications or otherwise challenge
the expert’s testimony at the administrative hearing.”).
Generally, presumptions are rebuttable. See, e.g., Hernandez
v. Garland, 52 F.4th 757, 767 (9th Cir. 2022) (rebuttable
presumption of reliability for government-prepared
document); Chenette v. Porch.com, Inc., 50 F.4th 1217,
1225 (9th Cir. 2022) (rebuttable presumption that cell
phones are residential); United States v. Wright, 49 F.4th
1221, 1226 (9th Cir. 2022) (rebuttable presumption that
defendant is lawfully entitled to seized property). We see no
reason to make an exception to that general rule here.
    Second, we consider whether the presumption was
rebutted in this case. When the ALJ asked about a limitation
to “medium work,” the vocational expert responded that
there would be work in the national economy and identified
three sample occupations. But when Conway’s counsel
expressly asked about a six-hour standing and walking
limitation, the vocational expert responded differently: He
testified that the three sample occupations could not
accommodate that “additional work restriction” and that it
would be “difficult” to provide substitute occupations. The
expert’s significantly different responses reveal that the
expert did not understand the ALJ’s hypothetical to
impliedly include a six-hour standing and walking
limitation. Therefore, the Terry presumption was rebutted.
                       CONWAY V. O’MALLEY                           9

    The Commissioner argues that the Terry presumption
was not rebutted because Conway’s counsel did not use the
same exact wording that the doctors used to describe
Conway’s limitation. An ALJ does not need to use “identical
wording” when describing a claimant’s limitations to the
vocational expert, “so long as the limitations are not
materially altered.” Id. at 1258. And, if the question does not
expressly describe a particular limitation, we also ask
whether the expert would have understood the question to
imply that limitation. Terry, 998 F.3d at 1014. Applying
these same standards to the question asked by Conway’s
counsel, we conclude that the question accurately described
Conway’s limitation.
    Specifically, the Commissioner argues that counsel’s
question was inaccurate because, in the Commissioner’s
view, the doctors did not find that Conway should be limited
to standing and walking limitation for a “maximum” of six
out of eight hours. The Commissioner, however, ignores that
the doctors found that Conway should have a standing and
walking “limitation” of “a total of: About six hours in an
eight-hour workday.” When a person is limited to standing
and walking for a “total” of six hours, six hours is the
maximum amount of time that the person should stand and
walk. 2 Counsel did not need to use identical wording to
describe Conway’s limitation, and counsel’s use of the word
“maximum” instead of “total” did not materially alter the
limitation.

2
   “Total” means “aggregate, sum,” or “an entire quantity or
configuration.” See Webster’s Third New Int’l Dictionary, 2414 (1981).
“Maximum” means an “upper limit allowed by law or other authority.”
Id. at 1396.
10                       CONWAY V. O’MALLEY

    The Commissioner also argues that counsel’s question
was inaccurate because it described a limitation of “six
hours” instead of “about six hours.” The omission of the
word “about” did not materially alter the limitation because
it was implied. When completing a physical RFC
assessment, doctors typically use the term “about” when
prescribing a limitation of “six hours in an eight-hour
workday”—just like Dr. Berner and Dr. Johnson did in this
case. 3 In other words, “about six hours in an eight-hour
workday” is a term of art that doctors commonly use in RFC
assessments. An expert who has significant experience in the
vocational rehabilitation field and as an expert witness in
social security cases is presumptively familiar with that term
of art. See Terry, 998 F.3d at 1013. And, in this case, it is
undisputed that the expert had such experience. Thus, when
Conway’s counsel asked the expert about a limitation of “six
out of eight hours,” the expert would have understood
counsel’s question to imply a limitation of “about six out of
eight hours.” See id. at 1014. Nothing in the expert’s

3
   See, e.g., Lee v. Berryhill, 721 F. App’x 604, 607 (9th Cir. 2017)
(“Nonexamining physicians Dr. Alley, Dr. Pritchard, and Dr. Eder all
conclude that Lee can . . . stand and/or walk about six hours in a
workday.”); Ludwig v. Astrue, 681 F.3d 1047, 1049 (9th Cir. 2012) (“The
Social Security Administration’s medical consultant . . . opined that
Ludwig could . . . stand or walk for about 6 hours in an 8-hour workday.
. . .”); Charmaine S. v. Comm’r of Soc. Sec. Admin., No. 3:20-CV-01313-
CL, 2022 WL 2072605, at *4 (D. Or. June 8, 2022), aff’d sub nom.
Simmons v. Kijakazi, No. 22-35627, 2023 WL 4173026 (9th Cir. June
26, 2023) (“State agency consultants Dr. Mark Magdaleno and Dr.
Gordon Hale both opined that Plaintiff was limited to . . . standing and/or
walking ‘about 6 hours in an 8-hour workday.’”); Robert C. v. Comm’r,
Soc. Sec. Admin., No. 3:21-CV-00712-HZ, 2022 WL 972410, at *2 (D.
Or. Mar. 30, 2022) (“Both consultants found that Plaintiff would be able
to ‘Stand and/or walk (with normal breaks) for a total of: About 6 hours
in an 8-hour workday.’”).
                     CONWAY V. O’MALLEY                     11

response to counsel’s question suggests that he understood
counsel to be asking about a limitation of precisely six hours.
Therefore, we conclude that counsel’s omission of the word
“about” did not materially alter the limitation.
    Because the ALJ’s hypothetical did not expressly
incorporate the six-hour standing and walking limitation,
and cross-examination revealed that the expert did not
understand the ALJ’s hypothetical to impliedly include that
limitation, the ALJ failed to accurately describe Conway’s
limitations. Consequently, the expert’s response to the ALJ’s
question “has no evidentiary value” to support the ALJ’s
“finding that the claimant can perform jobs in the national
economy.” Leach, 70 F.4th at 1255 (cleaned up).
    This error was not harmless because the expert testified
that a person with a six-hour standing and walking limitation
could not perform the three jobs he had identified and that
he would have difficulty providing substitutes at the medium
work level. Indeed, that expert testimony compels the
finding that there are not enough jobs in the medium work
range that Conway can perform. See Lingenfelter v. Astrue,
504 F.3d 1028, 1041 (9th Cir. 2007) (awarding benefits
where expert answered alternative hypothetical questions
that incorporated all of the claimant’s limitations); Varney v.
Sec’y of Health & Human Servs., 859 F.2d 1396, 1399–400
(9th Cir. 1988) (awarding benefits because “no further
proceedings are necessary to develop the administrative
record” where the expert’s response on cross-examination
established that there were no jobs the claimant could
perform); Gallant v. Heckler, 753 F.2d 1450, 1456 (9th Cir.
1984) (awarding benefits based on expert’s responses on
cross-examination).
12                       CONWAY V. O’MALLEY

     Still, remand is necessary because the agency may find
that a claimant who is “of advanced age (age 55 or older)”
and limited to sedentary or light work is not disabled if the
claimant has skills that are transferable to work he can
perform despite his impairments. See 20 C.F.R.
§ 404.1568(d)(4). And in this case, the ALJ did not ask the
expert whether there is light or sedentary work that someone
with Conway’s RFC can perform, or make findings about
the transferability of Conway’s skills to such work. 4 See SSR
82-41, 1982 WL 31389 at *7 (“When the issue of skills and
their transferability must be decided, the adjudicator or ALJ
is required to make certain findings of fact and include them
in the written decision.”). Consequently, we remand this
case to the Commissioner so that the ALJ can further
develop the record and make specific findings on whether
Conway has transferable work skills. See, e.g., Bray v.
Comm’r of Soc. Sec. Admin., 554 F.3d 1219, 1226 (9th Cir.
2009); Chavez v. Bowen, 844 F.2d 691, 694 (9th Cir. 1988).
                              Conclusion
    Where, as here, an ALJ uses the term “medium work” in
its hypothetical question, there is a presumption that the
expert understood that “‘medium work’ implies a six-hour
standing and walking limitation.” Terry, 998 F.3d at 1014.
However, that presumption was rebutted in this case
because, on cross-examination, Conway’s counsel explicitly
asked the expert about a six-hour standing and walking

4
  The ALJ concluded that “[t]ransferability of job skills is not material to
the determination of disability because using the Medical-Vocational
Rules as a framework supports a finding that the claimant is ‘not
disabled,’ whether or not the claimant has transferable job skills.” That
conclusion, however, is based on the ALJ’s unsupported finding that
there are enough medium jobs that Conway can perform.
                     CONWAY V. O’MALLEY                     13

limitation, and the vocational expert gave a different answer.
Indeed, the expert’s answer on cross-examination compels
the finding that there are not enough medium work jobs that
Conway can perform in the national economy. Therefore, the
ALJ’s contrary finding is not supported by substantial
evidence.
   REVERSED AND REMANDED.

RAWLINSON, Circuit Judge, dissenting:

    I respectfully dissent from the majority opinion because
it does not adhere to the substantial evidence standard of
review and because it fails to give proper deference to the
decision of the Administrative Law Judge (ALJ).
    Although the majority mentions the substantial evidence
standard of review in stating the issue before us, see Majority
Opinion, p. 6, it then proceeds to ignore the standard of
review in its analysis.
    I agree with the majority that the issue presented is
whether the decision of the ALJ is supported by substantial
evidence. After properly applying the substantial evidence
standard of review, rather than the de novo review conducted
by the majority, I conclude that the ALJ’s decision is
supported by substantial evidence in the record.
    When reviewing decisions of an ALJ, we apply the
substantial evidence standard of review. See Ahearn v. Saul,
988 F.3d 1111, 1115 (9th Cir. 2021). This is a deferential
standard of review. See id. “Substantial evidence means
such relevant evidence as a reasonable mind might accept as
adequate to support a conclusion. The evidence must be
more than a mere scintilla but may be less than a
14                   CONWAY V. O’MALLEY

preponderance. . . .” Id. (citation omitted). This standard “is
not high.” Biestek v. Berryhill, 139 S. Ct. 1148, 1154 (2019).
The United States Supreme Court has compared the
substantial evidence standard to that of clear error. See id.
And we have described this standard as “modest.” Smith v.
Kijakazi, 14 F.4th 1108, 1111 (9th Cir. 2021).
    In applying the substantial evidence standard of review,
“if evidence exists to support more than one rational
interpretation, we must defer to the [ALJ’s] decision.”
Batson v. Comm’r, 359 F.3d 1190, 1193 & n.1 (9th Cir.
2004) (citation omitted).
    This case turns on the meaning of “medium work.” The
applicable Social Security ruling defines medium work as
requiring “standing or walking, off and on, for a total of
approximately 6 hours in an 8-hour workday.” Social
Security Ruling (SSR) 83-10, 1983 WL 31251 at *6 (Jan. 1,
1983) (emphasis added); see also Terry v. Saul, 998 F.3d
1010, 1013 (9th Cir. 2021) (“In a 1983 published Social
Security Ruling, the [Social Security] Commissioner
interpreted medium work to require standing or walking, off
and on, for a total of approximately 6 hours in an 8-hour
workday.”), quoting SSR 83-10 (alteration and internal
quotation marks omitted) (emphasis added).
    In Terry, we clarified that an experienced Vocational
Expert (VE) would understand a reference to medium work
as incorporating the longstanding agency interpretation of
approximately six hours of standing or walking in an eight-
hour workday. See id. That is precisely what happened in
this case. The ALJ posed the following question to the VE:

       Question:       Assume    a   person . . . of
                       Claimant’s age, education,
                    CONWAY V. O’MALLEY                  15

                      and past work experience
                      [who is] limited to medium
                      work . . .”
                        ...
      Question:       Any medium work for such a
                      hypothetical person in the
                      national economy?
      Answer:         There would be, Your Honor.
                      Let me provide three sample
                      occupations.         So first,
                      unskilled, medium occupation
                      I . . . for this RFC would be
                      hospital housekeeper . . . SVP
                      [Specific            Vocational
                      Preparation] 2, and medium,
                      and I have an estimated
                      84,000        people   working
                      nationally. Second sample
                      occupation would be laundry
                      worker . . . SVP 2 and
                      medium, and we have an
                      estimated 92,000 people
                      working nationally, and then,
                      third would be dishwasher . . .
                      SVP 2, and medium, and we
                      have a little over 300,000
                      people working nationally.
                      So, these are three unskilled,
                      medium occupations . . .”

(Emphasis Added).
16                  CONWAY V. O’MALLEY

   On cross-examination, counsel for the claimant asked a
completely different question to the VE:

       Question:      Mr. Hincks, if someone’s only
                      able to be on their feet for six
                      out of eight hours, maximum,
                      would they be able to do any
                      medium work or the jobs you
                      listed?
       Answer:        The three sample occupations
                      would not comport with that
                      additional work restriction
                      and would be difficult for me
                      to      provide     substitute
                      unskilled,             medium
                      occupations where a worker
                      would be capped at being on
                      their feet no more than six
                      hours in a workday . . .

(Emphasis Added).
    The VE characterized the limitation to six hours
maximum as an “additional work restriction” that “would
not comport” with the “medium” work occupations he gave
as examples of work that the claimant could perform. From
this response, it is obvious that the VE did not consider
counsel’s question to incorporate the accepted definition of
medium work as requiring “standing or walking, off and on,
for a total of approximately 6 hours in an 8-hour workday.”
SSR 83-10, 1983 WL 31251 at *6 (emphasis added); Terry
998 F.3d at 1013 (emphasis added). Rather, counsel’s
question incorporated the “additional work restriction” of a
maximum of six hours standing or walking in an eight-hour
                    CONWAY V. O’MALLEY                     17

workday, as opposed to the accepted definition of
approximately six hours standing or walking in an eight-hour
workday.
    Having before him the VE’s responses to these two
different questions, it was well within the ALJ’s authority to
accept the VE’s response to his question, which incorporated
the accepted definition of medium work and not the VE’s
response to counsel’s question that included an “additional
work restriction” that did “not comport with” the accepted
definition of medium work. See Garrison v. Colvin, 759
F.3d 995, 1010 (9th Cir. 2014) (“The ALJ is responsible for
determining credibility, resolving conflicts in medical
testimony, and for resolving ambiguities. . . .”) (citation
omitted).
    In Terry, we explained that an experienced VE would
understand a reference to medium work as incorporating the
longstanding agency interpretation of approximately six
hours of standing or walking in an eight-hour workday. See
998 F.3d at 1013 (quoting SSR 83-10). Nothing about
counsel’s question to the VE casts doubt on the VE’s
understanding of the longstanding definition of medium
work. To the contrary, the VE clearly indicated the
distinction between his understanding of the longstanding
definition of medium work and the “additional work
restriction” of a maximum of six hours in a workday by
opining that under the accepted definition of medium work
there were jobs that the claimant could perform, but under
the “additional work restriction” added to the accepted
definition of medium work, the claimant could not perform
the jobs designated as medium work. This circumstance
more than satisfied the substantial evidence standard of
review. See Ahearn, 988 F.3d at 1115 (noting that the
substantial evidence standard is deferential); see also
18                  CONWAY V. O’MALLEY

Biestek, 139 S. Ct. at 1154 (clarifying that the substantial
evidence “is not high”); Smith, 14 F.4th at 1111 (describing
the standard as “modest”). Indeed, if there is more than one
rational interpretation of the evidence, “we must defer to the
[ALJ’s] decision.” Batson, 359 F.3d at 1193 & n.1 (citation
omitted).      The majority concludes that the ALJ’s
hypothetical was not accurate because it did not include the
six-hour standing/walking limitation. The majority bases
this conclusion on the fact that both medical experts found a
standing/walking limitation of “[a]bout six hours in an 8-
hour workday.” Majority Opinion, p. 7. But the medical
experts’ opinions of about six hours were consistent with the
longstanding definition of medium work as “approximately”
six hours in an eight-hour workday rather than with
counsel’s definition of medium work as a maximum of six
hours in an eight-hour workday.
    The majority also concludes that the presumption that the
ALJ and the VE shared an understanding regarding the
definition of medium work was rebutted by the VE’s
response to counsel’s question. However, as discussed, the
question asked by counsel was completely different and did
not incorporate the longstanding definition of medium work.
The VE clearly recognized the difference because he
characterized counsel’s question as adding “an additional
work limitation” of a maximum of six hours in a workday as
opposed to “approximately” or “about” six hours. Counsel’s
question deviated from the longstanding definition of
medium work as “approximately” six hours and from the
medical experts’ opinions of “about” six hours. The VE and
ALJ shared an understanding of “approximately” six hours
as evidenced by the VE’s different responses to the different
questions. The VE responded to the ALJ’s question
consistently with the longstanding definition of medium
                       CONWAY V. O’MALLEY                          19

work as “approximately” six hours in a workday by listing
medium work occupations. In contrast, the VE responded to
counsel’s question which was not consistent with the
longstanding definition of medium work by concluding that
the additional work limitation (a maximum of six hours
rather than “approximately” or “about” six hours) would
preclude medium work. 1
    The majority concludes “that counsel’s omission of the
word ‘about’ did not materially alter the limitation.”
Majority Opinion, p. 11. But not only is that conclusion an
impermissible de novo review of the ALJ’s decision, it is
belied by the record. The VE described counsel’s omission
of “about” as an “additional work limitation” that rendered
the claimant unable to perform medium work. Obviously
then, the VE did not understand counsel’s question to imply
“about six hours.” Nothing could be more material. And
even if that is the interpretation of the majority, the ALJ was
not required to adopt that interpretation. See Garrison, 759
F.3d at 1010.
    An everyday example illustrates the difference between
the two questions posed to the VE: If someone says that an
item costs $6.00, the general understanding would be that the
item costs exactly $6.00. On the other hand, if someone says

1
 “Approximately” means “[i]n an approximate manner, nearly; elliptical
with near approach to accuracy.” Approximately, OXFORD ENGLISH
DICTIONARY,
https://www.oed.com/dictionary/approximately_adv?tab=meaning_and
_use#198575 (last visited Mar. 13, 2024).
  “About” means “[e]xpressing approximation. Nearly, approximately,
more or less.”            About, OXFORD ENGLISH DICTIONARY,
https://www.oed.com/dictionary/about_adv?tab=meaning_and_use#67
85227 (last visited Mar. 13, 2024).
20                  CONWAY V. O’MALLEY

that an item costs “about” $6.00, the general understanding
would be that the item costs approximately $6.00, not
exactly $6.00. The same is true in this case. The
longstanding definition of medium work, which we presume
both the ALJ and VE were aware of, see Terry, 998 F.3d at
1013, was of “approximately” or “about” six hours in a
workday. Counsel’s definition, which omitted “about” or
“approximately” did not comport with the shared definition
of the ALJ and VE, as evidenced by the VE’s different
response to the question that did not include the longstanding
definition of medium work.
    In sum, the ALJ’s decision is supported by substantial
evidence, and he was not required to accept the VE’s answer
that was predicated on what the VE described as an
“additional work limitation” that was not part of the
longstanding definition of medium work shared by the ALJ,
the VE, and the medical experts. If remanded, all the ALJ
will do is reaffirm that he and the VE share the understanding
that medium work is “about six hours” in an eight-hour
workday, and that Conway’s RFC of medium work of about
six hours enabled him to perform the three jobs identified by
the VE. Because the majority unfortunately fails to apply
the substantial evidence standard of review and re-interprets
the record, I respectfully dissent.