Womack v. Bisignano

1 FILED IN THE U.S. DISTRICT COURT 2 EASTERN DISTRICT OF WASHINGTON Apr 22, 2026 3 SEAN F. MCAVOY, CLERK 4 5 UNITED STATES DISTRICT COURT 6 EASTERN DISTRICT OF WASHINGTON 7 JESSICA W., 8 No: 2:25-cv-00435-RLP Plaintiff, 9 v. ORDER AFFIRMING THE 10 COMMISSIONER’S DECISION FRANK BISIGNANO, 11 COMMISSIONER OF SOCIAL SECURITY, 12 Defendant. 13 14 BEFORE THE COURT is an appeal from an Administrative Law Judge 15 (ALJ) final decision denying disability income benefits under Title II of the Social 16 Security Act. ECF No. 12. The Court considered the matter without oral argument. 17 For the reasons discussed below, the Court concludes the ALJ’s decision is 18 supported by substantial evidence. Therefore, Ms. W.’s brief, ECF No. 12, is denied 19 and the Commissioner’s brief, ECF No. 15, is granted. 20 21 1 JURISDICTION 2 Ms. W. filed for disability insurance benefits (DIB) on April 1, 2023, alleging 3 an onset date of March 12, 2021. Tr. 203-06. Benefits were denied initially, Tr. 96- 4 105, and upon reconsideration, Tr. 107-14. Plaintiff appeared at a hearing before an 5 ALJ on December 31, 2024. Tr. 39-65. On August 7, 2025, the ALJ issued an 6 unfavorable decision, Tr. 14-37, and the Appeals Council denied review on August 7 26, 2025. Tr. 1-6. The matter is now before this Court pursuant to 42 U.S.C. § 8 405(g). 9 BACKGROUND 10 The facts of the case are set forth in the administrative hearings and 11 transcripts, the ALJ’s decision, and the briefs of Plaintiff and the Commissioner, and 12 are therefore require only brief summary. 13 Ms. W. was born in 1984 and was 36 years old on the alleged onset date. Tr. 14 30. She has a high school diploma. Tr. 46. She has work experience as an orchard 15 accounting clerk. Tr. 30, 46. Ms. W.’s claim for disability insurance benefits alleges 16 disability based on anxiety, OCD, COVID-19 long-haul problems, fibromyalgia, 17 Hashimoto’s, type one diabetes, and neuropsychological symptoms. Tr. 244. Ms. W. 18 testified that extreme anxiety and depression are the main impairments preventing 19 her from working. Tr. 49. She has difficulty stepping out of the house and seeing 20 people and spends a lot of time sleeping. Tr. 49. Physically, she experiences severe 21 pain and aches throughout her body. Tr. 51. She has fibromyalgia which was 1 intensified by COVID-19. Tr. 51. She experiences dizziness, loss of balance, brain 2 fog, cognitive dysfunction, and difficulty maintaining insulin levels with a pump. Tr. 3 53-56. 4 STANDARD OF REVIEW 5 A district court’s review of a final decision of the Commissioner of Social 6 Security is governed by 42 U.S.C. § 405(g). The scope of review under § 405(g) is 7 limited; the Commissioner’s decision will be disturbed “only if it is not supported by 8 substantial evidence or is based on legal error.” Hill v. Astrue, 698 F.3d 1153, 1158 9 (9th Cir. 2012). “Substantial evidence” means “relevant evidence that a reasonable 10 mind might accept as adequate to support a conclusion.” Id. at 1159 (quotation and 11 citation omitted). Stated differently, substantial evidence equates to “more than a 12 mere scintilla[,] but less than a preponderance.” Id. (quotation and citation omitted). 13 In determining whether the standard has been satisfied, a reviewing court must 14 consider the entire record as a whole rather than searching for supporting evidence in 15 isolation. Id. 16 In reviewing a denial of benefits, a district court may not substitute its 17 judgment for that of the Commissioner. Edlund v. Massanari, 253 F.3d 1152, 1156 18 (9th Cir. 2001). If the evidence in the record “is susceptible to more than one 19 rational interpretation, [the court] must uphold the ALJ’s findings if they are 20 supported by inferences reasonably drawn from the record.” Molina v. Astrue, 674 21 F.3d 1104, 1111 (9th Cir. 2012). Further, a district court “may not reverse an ALJ’s 1 decision on account of an error that is harmless.” Id. An error is harmless “where it 2 is inconsequential to the [ALJ’s] ultimate nondisability determination.” Id. at 1115 3 (quotation and citation omitted). The party appealing the ALJ’s decision generally 4 bears the burden of establishing that it was harmed. Shinseki v. Sanders, 556 U.S. 5 396, 409-10 (2009). 6 FIVE-STEP EVALUATION PROCESS 7 A claimant must meet two criteria to be considered “disabled” within the 8 meaning of the Social Security Act. First, the claimant must be “unable to engage in 9 any substantial gainful activity by reason of any medically determinable physical or 10 mental impairment which can be expected to result in death or which has lasted or 11 can be expected to last for a continuous period of not less than twelve months.” 42 12 U.S.C. §§ 423(d)(1)(A). Second, the claimant’s impairment must be “of such 13 severity that he is not only unable to do his previous work[,] but cannot, considering 14 his age, education, and work experience, engage in any other kind of substantial 15 gainful work which exists in the national economy.” 42 U.S.C. § 423(d)(2)(A). 16 The Commissioner has established a five-step sequential analysis to determine 17 whether a claimant satisfies the above criteria. See 20 C.F.R. § 404.1520(a)(4)(i)-(v). 18 At step one, the Commissioner considers the claimant’s work activity. 20 C.F.R. § 19 404.1520(a)(4)(i). If the claimant is engaged in “substantial gainful activity,” the 20 Commissioner must find that the claimant is not disabled. 20 C.F.R. § 404.1520(b). 21 At step two, the Commissioner considers the severity of the claimant’s impairment. 1 20 C.F.R. § 404.1520(a)(4)(ii). If the claimant suffers from “any impairment or 2 combination of impairments which significantly limits [his or her] physical or 3 mental ability to do basic work activities,” the analysis proceeds to step three. 20 4 C.F.R. § 404.1520(c). At step three, the Commissioner compares the claimant’s 5 impairment to severe impairments recognized by the Commissioner to be so severe 6 as to preclude a person from engaging in substantial gainful activity. 20 C.F.R. § 7 404.1520(a)(4)(iii). 8 If the severity of the claimant’s impairment does not meet or exceed the 9 severity of the enumerated impairments, the Commissioner must assess the 10 claimant’s residual functional capacity (RFC). At step four, the Commissioner 11 considers whether, in view of the claimant’s RFC, the claimant is capable of 12 performing work that he or she has performed in the past (past relevant work). 20 13 C.F.R. § 404.1520(a)(4)(iv). At step five, the Commissioner considers whether, in 14 view of the claimant’s RFC, age, education, and past work experience, the claimant 15 is capable of performing other work in the national economy. 20 C.F.R. § 16 404.1520(a)(4)(v). 17 The claimant bears the burden of proof at steps one through four above. 18 Tackett v. Apfel, 180 F.3d 1094, 1098 (9th Cir. 1999). If the analysis proceeds to 19 step five, the burden shifts to the Commissioner to establish (1) the claimant is 20 capable of performing other work; and (2) such work “exists in significant numbers 21 1 in the national economy.” 20 C.F.R. § 404.1560(c)(2); Beltran v. Astrue, 700 F.3d 2 386, 389 (9th Cir. 2012). 3 ALJ’S FINDINGS 4 At step one, the ALJ found Ms. W. has not engaged in substantial gainful 5 activity since March 12, 2021, the alleged onset date. Tr. 20. At step two, the ALJ 6 found that Ms. W. has the following severe impairments: fibromyalgia, obesity, 7 diabetes, depressive disorder, obsessive compulsive disorder, and anxiety disorders. 8 Tr. 20. 9 At step three, the ALJ found Ms. W. does not have an impairment or 10 combination of impairments that meets or medically equals the severity of one of the 11 listed impairments. Tr. 20. With respect to the RFC, the ALJ found Ms. W. has the 12 capacity to perform light work with the following additional limitations: 13 frequently climb ramps and stairs; never climb ladders, ropes, or scaffolds; occasional balancing, stooping, kneeling, 14 crouching and crawling; occasional exposure to extreme vibration; no exposure to hazards such as unprotected heights 15 and dangerous machinery; working in approximately two-hour intervals with standard work breaks provided; occasional, 16 superficial interaction with the public; working in proximity to co-workers but no collaborative tasks; able to accept 17 instructions from a supervisor; and occasional, routine workplace changes. 18 Tr. 22. 19 At step four, the ALJ found Ms. W. is able to perform past relevant work as 20 an accounting clerk. Tr. 30. Alternatively, at step five, after considering Ms. W.’s 21 1 ALJ found there are other jobs that exist in significant numbers in the national 2 economy that Ms. W. can perform such as administrative clerk, file clerk, and 3 general clerk. Tr. 31. 4 Thus, the ALJ found Ms. W. has not been under a disability, as defined in the 5 Social Security Act, from March 12, 2021, through the date of the decision. Tr. 31. 6 ANALYSIS 7 Ms. W. alleges the ALJ made several errors in concluding she is not disabled. 8 Specifically, she contends the ALJ erred by (1) failing to properly consider her 9 allegations about the impact of her symptoms on her ability to work; (2) improperly 10 evaluating the persuasiveness of the medical opinion evidence; and (3) applying the 11 wrong legal standard and improperly disregarding lay witness statements. Ms. W. 12 argues the wrongly discounted evidence supports greater limitations than included in 13 the RFC and ultimately impacts the ALJ’s conclusion that she was not disabled. She 14 contends the proper remedy is to remand this matter for further proceedings. 15 The Court concludes the ALJ did not err in evaluating Ms. W.’s symptom 16 testimony or the medical opinion evidence, and that the ALJ’s consideration of the 17 lay witness statements is legally sufficient. Each of Ms. W.’s claims of error are 18 addressed in turn. 19 1. Symptom Testimony 20 A two-step process applies to an ALJ’s assessment of a claimant’s testimony 21 regarding subjective pain and symptoms. “First, the ALJ must determine whether 1 there is objective medical evidence of an underlying impairment which could 2 reasonably be expected to produce the pain or other symptoms alleged.” Molina, 674 3 F.3d at 1112 (internal quotation marks omitted). Second, if there is such evidence 4 and there is no sign of malingering, the claimant’s testimony should generally be 5 accepted unless there is clear and convincing evidence in support of rejection. See 6 Garrison v. Colvin, 759 F.3d 995, 1015 (9th Cir. 2014). “[T] he ALJ can only reject 7 the claimant’s testimony about the severity of the symptoms if [the ALJ] gives 8 ‘specific, clear and convincing reasons’ for the rejection.” Ghanim v. Colvin, 763 9 F.3d 1154, 1163 (9th Cir. 2014) (internal citations and quotations omitted). “General 10 findings are insufficient; rather, the ALJ must identify what testimony is not credible 11 and what evidence undermines the claimant’s complaints.” Id. (quoting Lester v. 12 Chater, 81 F.3d 821, 834 (9th Cir. 1995)). 13 The ALJ found Ms. W.’s medically determinable impairments could 14 reasonably be expected to cause only some of the symptoms alleged and that her 15 statements about the intensity, persistence, and limiting effects of even those 16 symptoms that are supported are not entirely consistent with the medical evidence 17 and other evidence in the record. Tr. 23. The ALJ found: (1) fibromyalgia and 18 diabetes are controlled or improved with treatment; (2) Ms. W.’s testimony is not 19 consistent with her symptom reports in the treatment record; (3) the record indicates 20 Ms. W. consistently presented with unremarkable findings which is inconsistent with 21 the alleged severity of symptoms and functional limitation; (4) her presentation at a 1 consultative exam suggests exaggeration of symptoms; (5) Ms. W.’s allegations 2 regarding mental symptoms are inconsistent with each other; (6) the mental health 3 record suggests a good response to treatment; (7) Ms. W.’s activities are not entirely 4 consistent with her allegations, including driving and travel to other states. Tr. 24- 5 25. 6 Ms. W.’s complaints about the decision are focused primarily on the ALJ’s 7 consideration of her fibromyalgia and mental health symptoms. Pursuant to Social 8 Security Ruling 12-2p, in evaluating the RFC of a claimant with fibromyalgia, the 9 ALJ must consider “all relevant evidence in the case record” and the longitudinal 10 record whenever possible because the symptoms of fibromyalgia can wax and wane 11 so that a person may have “bad days and good days.” Social Security Ruling 12-2p, 12 2012 WL 3104869 (effective July 25, 2012). 13 Improvement with Treatment 14 Ms. W. does not challenge the ALJ’s determination that her diabetes is 15 controlled with treatment. She contends the record does not reflect her fibromyalgia 16 is similarly controlled. Ms. W. notes the ALJ cited a single record from January 17 2024 indicating she “feels that her fibromyalgia regiment is working well.” Tr. 24 18 (citing Tr. 842). Ms. W. cites other records from January and November 2021 19 indicating that since coming down with COVID-19, she was struggling with 20 symptoms such as fatigue, myalgias, diffuse body aches and pain and anxiety. 21 However, in February 2022, she reported feeling a lot better with medication, noting 1 less pain and improved brain fog. Tr. 653. In January 2023, there was “[s]atisfactory 2 control of symptoms on current regimen.” Tr. 648. These records cited by Ms. W. 3 appear to support the ALJ’s finding that treatment was effective at that point. 4 By May 2023, Ms. W. experienced an exacerbation of fibromyalgia and her 5 medication was changed to gabapentin. Tr. 734. There appear to be no records or 6 comments regarding fibromyalgia from May 2023 to January 2024. In January 2024, 7 Ms. W. reported her medication was working well. Tr. 842. A few months later, in 8 April 2024, she was struggling with myalgias, gabapentin was providing minimal 9 relief, and she was not taking care of her diabetes very well. Tr. 1751. Her 10 medication was adjusted. Tr. 1753. In May 2024, she had a new symptom of 11 paresthesias and skin allodynia; Ms. W. was worried about multiple sclerosis, so an 12 MRI and labs were ordered. Tr. 1721-22. In July 2024, during a follow up 13 appointment, Ms. W. reported Lyrica helped more than gabapentin and her skin 14 allodynia had subsided, but she had brain fog and was sometimes woozy. Tr. 1603. 15 In November 2024, she was noted to be intolerant of gabapentin, Lyrica, and 16 amitriptyline and felt more mentally clear without the medications, yet she struggled 17 with a lot of pain from fibromyalgia. Tr. 1486. Nonmedicinal interventions were 18 recommended such as stretching, yoga, and warm baths. A new medication was 19 prescribed. Tr. 1486. 20 Ms. W. contends these records demonstrate her fibromyalgia symptoms were 21 not controlled by medication, but that her medications were adjusted over time as 1 her symptoms waxed and waned. That interpretation of the record may be a 2 reasonable one; but it does not follow that the ALJ’s interpretation of the record is 3 incorrect. Where the evidence conflicts, it is the ALJ’s duty to resolve the ambiguity. 4 See Morgan v. Commissioner, 169 F.3d 595, 599-600 (9th Cir. 1999). We will not 5 reverse credibility determinations of an ALJ based on contradictory or ambiguous 6 evidence. Johnson v. Shalala, 60 F.3d 1428, 1434 (9th Cir. 1995) (citing Allen v. 7 Heckler, 749 F.2d 577, 579 (9th Cir.1984)). However, even if this was error, it 8 would be harmless error. An error is harmless if it is “inconsequential to the ultimate 9 nondisability determination.” Ford v. Saul, 950 F.3d 1141, 1154 (9th Cir. 2020) 10 (citation omitted). Because the ALJ provided other clear and convincing reasons 11 supported by substantial evidence, such as inconsistency with the medical record and 12 inconsistency with Ms. W.’s travel activities which are discussed below, the 13 outcome would not be changed despite any error. See Carmickle v. Comm’r of Soc. 14 Sec. Admin, 533 F.3d 1155, 1162 (9th Cir. 2008. 15 Clinical Presentation 16 The ALJ found Ms. W.’s clinical presentation was consistently unremarkable, 17 which is inconsistent with alleged level of symptom severity and functional 18 limitations. The ALJ noted one report of transient lower extremity swelling, Tr. 19 1037-38, but otherwise largely normal findings of no acute distress, no abnormalities 20 in gait, ambulation, balance, sensation, reflexes, motor function, or muscle strength. 21 Tr. 24 (citing e.g., Tr. 843, 1037-38, 1068, 1125-26, 1178-80, 1411, 1460, 1486, 1 1497-98, 1558, 1663, 1668, 1876, 1935-36). The ALJ observed that despite Ms. 2 W.’s allegations of dizziness and poor balance, there is no indication that any 3 provider recommended an assistive device. 4 Ms. W. contends the ALJ erred by finding her clinical presentation was 5 inconsistent with her allegations regarding fibromyalgia. She argues that some of the 6 citations given by the ALJ involved appointments that were not for fibromyalgia. 7 ECF No. 12 at 8 (citing Tr. 1037-38, 1068, 1179-80, 1411, 1460, 1497-98). This 8 argument is unpersuasive. While some of the records do not specifically involve 9 treatment of fibromyalgia, these are not like the records at issue in Diedrich v. 10 Berryhill, 874 F.3d 634 (9th Cir. 2017), cited by Ms. W. In that case, the ALJ noted 11 an absence of mental health symptoms in the treatment record of an orthopedist. 12 Here, the ALJ cited records involving evaluations by Ms. W.’s treating practitioners 13 for follow up her various physical conditions. The fact that not every appointment 14 involved specific assessment of fibromyalgia lends weight to the ALJ’s point rather 15 than undermines it. Furthermore, the ALJ is tasked with evaluating the longitudinal 16 record, so an observation of normal or minimal findings over the course of the 17 record is an appropriate consideration. 18 Plaintiff also points out that other records cited by the ALJ indicated she had 19 heightened sensitivity to pain and positive tender points, which are objective signs of 20 fibromyalgia documented by her providers. ECF No. 12 at 8 (citing Tr. 734, 1486, 21 1721). Yet the ALJ did not dismiss Ms. W.’s fibromyalgia, as the ALJ found 1 fibromyalgia is a severe impairment, Tr. 20, considered records indicating symptoms 2 from fibromyalgia, Tr. 23, and assessed physical restrictions in the RFC due in part 3 to fibromyalgia. Tr. 22. In evaluating Ms. W.’s symptoms statements, however, the 4 ALJ’s observations about her presentation in the medical record are relevant and 5 supported by substantial evidence. 6 Inconsistent Symptom Reports 7 Ms. W. does not challenge the ALJ’s finding that certain symptom reports in 8 the treatment record are not consistent with her testimony. Tr. 25. The ALJ observed 9 Ms. W. testified she cannot work because of leg pain, difficulty standing, she 10 constantly feels like she is about to pass out; she has to hold onto something because 11 of poor balance, and she has to have her husband or daughter nearby to help prevent 12 falls. Tr. 24, 52-54. The ALJ noted, however, that the record reflects few mentions 13 of leg pain, poor balance, or feeling faint, see Tr. 963-1783, 1855-1938, and that 14 while dizziness was mentioned a few times, Tr. 1493, 1612, 1729, she also denied 15 dizziness on several occasions, e.g., Tr. 810, 1552, and most records do not indicate 16 complaints of dizziness. This is a clear and convincing reason supported by 17 substantial evidence. 18 Exaggeration 19 The ALJ found Ms. W.’s presentation during a September 2023 consultative 20 examination for disability benefits was markedly different than her presentation in 21 the treatment record, which the ALJ concluded suggests she was exaggerating her 1 symptoms at the examination. Tr. 24. For example, during the exam, Ms. W. 2 complained of being extremely weak in her upper and lower body, her large joints 3 hurt at all times, she had a hard time maintaining balance, she ran out breath easily 4 and needed to take frequent breaks due to fatigue. Tr. 793. The examiner, Oscar Del 5 Valle, ARNP, found severe deficits in balance, walking, range of motion, and 6 breathing. Tr. 797-98. The ALJ noted these findings contrast with the treatment 7 record reflecting few complaints of poor balance or dizziness; no complaints of 8 significant, ongoing respiratory or breathing issues; and few complaints of joint 9 stiffness. Tr. 24-25. The ALJ observed the treatment record generally reflected 10 benign presentation with no acute distress, no abnormalities in gait, ambulation, 11 balance, sensation, reflexes, breathing, range of motion, motor function, or muscle 12 strength. Tr. 25 (citing Tr. 843, 1037-38, 1068, 1125-26, 1178-80, 1411, 1460, 1486, 13 1497-98, 1558, 1663, 1668, 1876, 1935-36). Ms. W. does not challenge this finding 14 except as it relates to consideration of Mr. De Valle’s opinion, discussed below. This 15 is a clear and convincing reason supported by substantial evidence. 16 Mental Health Testimony 17 The ALJ found Ms. W.’s testimony regarding her mental symptoms is 18 inconsistent with her other symptom statements. The ALJ noted the Function Report 19 completed by Ms. W. in April 2024 alleges significant problems with remembering, 20 understanding, concentrating, getting along with others, and following spoken and 21 written instructions. Tr. 25 (citing 305-13; see Tr. 311). According to the ALJ, at the 1 December 2024 hearing, Ms. W. only briefly mentioned mental impairments yet 2 testified at length about her physical impairments. Tr. 25. However, as Ms. W. 3 observes, at the hearing Ms. W. testified she has “memory issues” (Tr. 48), she has 4 “extreme anxiety” that is “debilitating” and she “can’t even fathom stepping out of 5 my house and seeing people” (Tr. 49). She testified that she could not go back to 6 work in accounting because “I can’t even make sense of a simple question and 7 concentration. I can’t – yea, the brain fog and the [cognitive] dysfunction.” Tr. 54. 8 The Court agrees with Ms. W. that her testimony at minimum touched on 9 functioning related to the allegations in her Function Report, even if each allegation 10 was not directly addressed. The ALJ’s finding is not supported by substantial 11 evidence. However, the error is harmless because the ALJ gave other clear and 12 convincing reasons supported by substantial evidence, including that the record 13 demonstrates a good response to mental health treatment and Ms. W.’s allegations 14 are inconsistent with the observations and complaints in the treatment record. See 15 Carmickle, 533 F.3d at 1162-63. 16 Mental Health Treatment 17 The ALJ found the mental health record suggests a good response to 18 treatment. The ALJ noted Plaintiff improved with treatment in March 2021 (Tr. 19 1336), there was ongoing improvement and stability later in 2021 (Tr. 1299, 1288, 20 1277, 1208), by January 2022, Ms. W. reported doing well with no significant 21 symptoms (Tr. 1197), in June 2022, everything was going really well and her 1 psychiatric symptoms were well managed (Tr. 1150), and mental health treatment 2 records through 2024 indicating stability of Ms. W.’s mental symptoms Tr. 972-73, 3 979, 986, 1003, 1062, 1085, 1091, 1138, 1144, 1155, 1161, 1167, 1789, 1803, 1824. 4 In further support, the ALJ acknowledged there were some findings of anxious (or 5 constricted) affect in the record but noted that mental status exams had largely 6 unremarkable findings regarding affect, behavior, memory, concentration, speech, 7 and other aspects of mental functioning. Tr. 1085, 1155, 1161, 1197, 1277, 1288, 8 1299, 1460, 1486, 1497, 1558. 9 Plaintiff argues generally these records do not support the ALJ’s finding and 10 calls the ALJ’s citations selective; however, she does not cite any records showing 11 the ALJ’s finding is incorrect or overstated. The ALJ cited findings over the 12 longitudinal record supporting the reasonable conclusion that Ms. W.’s mental 13 health stabilized with treatment. This is a clear and convincing reason supported by 14 substantial evidence. 15 Activities 16 The ALJ found Ms. W.’s activities are not entirely consistent with her 17 allegations, including driving and travel to other states. The ALJ observed that an 18 April 2024 function report completed by Ms. W. indicates she cannot drive, Tr. 309, 19 but other records show she drives on a regular basis, e.g. Tr. 436, 631, 788, and she 20 testified that she drives her daughter to school, Tr. 49. Ms. W. contends that at the 21 time of the function report, she was unable to drive due to problems with her vision, 1 which later improved with treatment. Tr. 847-499 (January 2024), 1508-09 2 (September 2024). Indeed, the function report referenced by the ALJ states that she 3 does not drive because “my vision retinopathy in both eyes.” Tr. 309. Accordingly, 4 the ALJ’s finding is not fully supported by the record. However, the ALJ gave other 5 clear and convincing reasons for giving less weight to Ms. W.’s symptom 6 statements, such as inconsistency with the medical record and inconsistency with her 7 travel activities (discussed below), so any error is harmless. See Ford, 950 F.3d at 8 1154; Carmickle, 533 F.3d at 1162-63. The ALJ further found that driving is 9 inconsistent with Ms. W.’s allegations of severe leg pain and poor concentration and 10 focus, which is not addressed by Ms. W. 11 The ALJ also found that Ms. W. engaged in travel inconsistent with her 12 allegations. In June 2022, she told her mental health provider she had summer travel 13 plans. Tr. 188. The record reflects she traveled to Lake Tahoe and Las Vegas, which 14 involved air travel. Tr. 1132, 1138. She flew alone and managed an 8-hour layover 15 in Seattle with no panic attacks. Tr. 1173. In August 2022, she stated she “was able 16 to travel alone and I didn’t have to take my anxiety medication.” Tr. 1132. The ALJ 17 noted she did not report any issues to her providers regarding walking or other 18 difficulties during travel. Tr. 26. Therefore, the ALJ found that physically, Ms. W.’s 19 ability to travel in combination with other findings in the record is not consistent 20 with her allegations of problems standing, walking, and balancing. Mentally, the 21 ALJ found that air travel requires the ability to interact with others and tolerate 1 crowds, which suggests generally intact social functioning. Tr. 26. Ms. W. contends 2 the ALJ should have further developed the record regarding her travel activities but 3 does not address the ALJ’s finding that her travel is inconsistent with her alleged 4 limitations. The ALJ’s characterization of Ms. W.’s travel activities is supported by 5 the record and this is a clear and convincing reason. 6 2. Medical Opinions 7 Ms. W. contends the ALJ failed to adequately evaluate the medical opinions 8 of Jeanette Higgins, Psy.D., and Oscar del Valle, ARNP. According to Ms. W., if 9 credited, the limitations assessed by these sources would result in a more restrictive 10 residual functional capacity finding, which could lead to a disability finding. 11 An ALJ must consider and evaluate the persuasiveness of all medical opinions 12 or prior administrative medical findings from medical sources. 20 C.F.R. § 13 404.1520c. Supportability and consistency are the most important factors in 14 evaluating the persuasiveness of medical opinions and prior administrative findings, 15 and therefore the ALJ is required to explain how both factors were considered. 20 16 C.F.R. § 404.1520c(b)(2). The ALJ may, but is not required, to explain how other 17 factors were considered. 20 C.F.R. § 404.1520c(b)(2); see 20 C.F.R. § 18 404.1520c(c)(1)-(5). 19 Jeannette Higgins, Psy.D. 20 In September 2023, Dr. Higgins, a consultative examiner, evaluated Ms. W. 21 and diagnosed major depressive disorder, generalized anxiety disorder, and 1 depressive disorder due to a medical condition. Tr. 790. Dr. Higgins opined Ms. W. 2 would not have difficulty performing simple and repetitive tasks; would not have 3 difficulty performing detailed and complex tasks on a consistent basis; would not 4 have difficulty accepting instructions from supervisors; would have difficulty 5 interacting with coworkers and the public; would have difficulty performing work 6 activities on a consistent basis without special or additional instructions; would have 7 difficulty maintaining regular attendance and completing a normal workday or 8 workweek; and would have difficulty dealing with usual stress encountered in the 9 workplace. Tr. 790-91. 10 The ALJ found the opinion partially persuasive. The ALJ found the portion of 11 the opinion assessing no limitations on the ability to perform simple and complex 12 tasks and accept instructions from supervisors is generally consistent with the 13 longitudinal record. The ALJ found the assessment of more severe limitations in 14 several areas is inconsistent with the longitudinal record which reflects stable, 15 controlled mental symptoms, normal mental status exam findings, and Ms. W.’s 16 ability to travel by plane and drive a car. Tr. 29. As discussed above, the ALJ’s 17 findings regarding these issues are supported by substantial evidence. Therefore, the 18 conclusion that the more severe limitations assessed by Dr. Higgins are inconsistent 19 with the record is supported by substantial evidence. 20 The ALJ also rejected Dr. Higgins’ limitations because she used the language 21 “would have difficulty” to describe limitations and did not specifically rate the level 1 of functional limitation. While the ALJ is “responsible for translating and 2 incorporating clinical findings into a succinct RFC,” Rounds v. Comm’r Soc. Sec. 3 Admin., 807 F.3d 996, 1006 (9th Cir. 2015), an ALJ may reject an opinion that does 4 not show how symptoms translate into specific functional deficits, Morgan, 169 F.3d 5 at 601. Ms. W. has not challenged this finding or addressed this reasoning. 6 Regarding supportability, the ALJ found the limitations that Ms. W. “would 7 have difficulty” interacting with coworkers and the public, performing work on a 8 consistent basis without additional instructions, maintaining regular attendance, and 9 dealing with usual stress encountered in the workplace to be conclusory and 10 unsupported. Ms. W. contends the ALJ’s erred because Dr. Higgins referred to 11 specific findings and observations she relied on in making these conclusions. Ms. W. 12 is correct that for each limitation, Dr. Higgins stated the basis for her conclusion. 13 The limitation that Ms. W. would have difficulty with coworkers and the public is 14 “based on observed anxiety symptoms manifested as avoidance and emotional 15 dysregulation under anticipatory, real, or perceived pressure;” the limitation of 16 difficulty performing work activities on a consistent bases is “due to difficulty with 17 some items of the mini mental status exam (i.e., memory, concentration, 18 calculations, serial 7s)”; the limitation of difficulty maintaining regular work 19 attendance is “based on depression and anxiety manifested as avoidance, apathy, and 20 lack of energy and motivation;” and the limitation of difficulty dealing with the 21 1 usual stress of the workplace “based on anxiety manifested as avoidance and 2 emotional dysregulation under real or perceived pressure and stress.” Tr. 789-90. 3 In other words, Dr. Higgins explained the bases for the limitations she 4 assessed yet the ALJ failed to evaluate or consider those in finding the opinion is 5 unsupported. Accordingly, the ALJ’s conclusion that the limitations assessed by Dr. 6 Higgins are conclusory is not based on substantial evidence. The question is whether 7 this error is harmless error. In an unpublished decision, the Ninth Circuit determined 8 an ALJ appropriately found a provider’s opinion unpersuasive because the opinion 9 was inconsistent with other medical evidence in the record, even though the opinion 10 was supported. Allen v. Kijakazi, 2023 WL 2728857, at *1 (9th Cir. Mar. 31, 2023) 11 (unpublished). Similarly, the ALJ in this case appropriately found Dr. Higgins’ 12 opinion unpersuasive because the opinion was inconsistent with the longitudinal 13 mental health record reflecting stable, controlled mental symptoms, normal mental 14 status exam findings, and the ability to travel (discussed supra), even though Dr. 15 Higgins referred to findings in support of the assessed limitations. Because the 16 ALJ’s consistency finding is supported by substantial evidence, the ALJ’s 17 consideration of Dr. Higgins’ opinion overall is supported by substantial evidence, 18 and any error is harmless. 19 Oscar Del Valle, ARNP 20 Mr. Del Valle examined Ms. W. and prepared a physical evaluation in 21 September 2023. Tr. 793-98. Mr. Del Valle listed diagnoses of shortness of breath 1 secondary to COVID, multiple joint pain/discomfort (fibromyalgia), poor balance, 2 chronic dizziness and weakness, and depression and anxiety. Tr. 797. His functional 3 assessment included limitations of: stand or walk no more than three hours; able to 4 sit eight hours with normal breaks; able to lift, carry and push/pull up to five pounds 5 occasionally and frequently; never perform climbing, kneeling, crouching, crawling, 6 and stooping; reaching, handling, fingering, and feeling are not limited; working at 7 heights or heavy machinery should be avoided/limited. Tr. 797-98. 8 The ALJ found Mr. Del Valle’s opinion is not persuasive. Tr. 28. First, the 9 ALJ found the opinion was insufficiently supported because Mr. Del Valle had a 10 limited understanding of the overall picture because he saw Ms. W. one time and 11 reviewed few treatment notes. Tr. 28. Second, the ALJ found Mr. Del Valle’s exam 12 findings and assessed limitations are inconsistent with the overall record. Tr. 28. 13 Ms. W. contends the ALJ’s finding “was predicated on believing that Plaintiff 14 credibly fakes all of the aspects of her presentation during the examination in such a 15 manner that ARNP del Valle was unaware of the deception.” ECF No. 12 at 15. As 16 noted above, the ALJ found the difference between Ms. W.’s presentation at Mr. Del 17 Valle’s exam and elsewhere in the record “suggests that she was exaggerating her 18 symptoms” during the exam. Tr. 24. A finding of exaggeration is not synonymous 19 with a finding that Ms. W. was intentionally deceptive or faking symptoms. The ALJ 20 pointed to numerous treatment records from various sources across the period at 21 issue which do not reflect the degree of symptoms observed by Mr. Del Valle. Tr. 28 1 (citing e.g., Tr. 843, 1038, 1068, etc., as discussed supra). Ms. W. again argues these 2 records are not relevant. However, as discussed above, many of the records cited by 3 the ALJ were from treating providers who conducted physical exams with minimal 4 findings. And Ms. W. does not cite any other records indicating findings or 5 complaints consistent with the level of poor balance, shortness of breath, dizziness, 6 and reduced range of motion recorded by Mr. Del Valle. 7 In addition to finding Mr. Del Valle’s opinion inconsistent with the record, the 8 ALJ found the opinion of Dr. Paula L., M.D., to be more persuasive. Tr. 28. Dr. L. 9 reviewed the record and found Ms. W. can occasionally lift or carry 25 pounds and 10 can frequently lift or carry 20 pounds, can stand and walk six hours in an eight-hour 11 workday, can sit six hours in an eight-hour workday, can occasionally balance, 12 stoop, or crouch but never climb ladders, ropes, or scaffolds, and should not work at 13 heights or around machinery and should avoid moderate exposure to vibration. Tr. 14 86-87. The ALJ observed Dr. L. cited evidence to substantiate her opinion and 15 reflects the most comprehensive view of the longitudinal evidence. Tr. 27. 16 Accordingly, the ALJ’s finding is supported by substantial evidence. 17 3. Lay Witness Statement 18 Ms. W. contends the ALJ applied the wrong legal standard in considering the 19 lay witness statements from her husband, Tr. 279-80, 498, her mother, Tr. 494, a 20 former co-worker, Tr. 496, and her sister-in-law, Tr. 497. The ALJ acknowledged 21 the statements and said they were considered but noted that he was not required to 1 articulate how they were considered. Tr. 30. Indeed, 20 C.F.R. § 404.1520c(d) 2 provides the Commissioner is “not required to articulate how we considered 3 evidence from nonmedical sources using the requirements [for considering medical 4 sources].” However, the Ninth Circuit has not yet determined whether the revised 5 regulations no longer require an ALJ to articulate any reason for rejecting lay 6 testimony. See Williams v. O'Malley, 2024 WL 3519774, at *3 n.4 (9th Cir. July 24, 7 2024). Whether an ALJ must still provide germane reasons to reject a nonmedical 8 statement remains an open question. See Donnelly, v. Commissioner of Social 9 Security, 2025 WL 1473954, at *14 (E.D. Cal. May 22, 2025). As such, the ALJ did 10 not apply the wrong legal standard. Even assuming the ALJ’s lack of explanation 11 was error, any error was harmless. See Ford, 950 F.3d at 1154. The lay witness 12 statements essentially refer to the same symptom allegations made by Ms. W. As 13 discussed above, the ALJ’s findings about Ms. W.’s symptom statements are 14 supported by substantial evidence. Nothing in the lay witness statements would 15 change ALJ’s conclusions based upon the evidence of record. See Molina, 674 F.3d 16 at 1115. The ALJ’s finding is not based on error. 17 CONCLUSION 18 Having reviewed the record and the ALJ’s findings, this Court concludes the 19 ALJ’s decision is supported by substantial evidence and free of harmful legal error. 20 The Court affirms the Commissioner’s decision. 21 1 Accordingly, IT IS ORDERED: 2 1. Plaintiff’s Brief, ECF No. 12, is DENIED. 3 2. Defendant’s Brief, ECF No. 15, is GRANTED. 4 IT IS SO ORDERED. The District Court Clerk is directed to enter this 5 || Order and provide copies to counsel. Judgment shall be entered for the Defendant 6|| and the file shall be CLOSED. 7 DATED April 22, 2026. 9 REBECCA LCSPENNELL United States District Judge 10 11 12 13 14 15 16 17 18 19 20 21 ORDER AGEIR MING THE CONMNMITCOTIONER?S NECTCION _ 94