Elijah Sims, Jr. v. Nancy Berryhill
704 F. App'x 703
| 9th Cir. | 2017Background
- Plaintiff Elijah Sims applied for Social Security disability benefits alleging chronic back and neck pain; ALJ denied benefits and district court affirmed; Sims appealed to Ninth Circuit.
- Sims’s treating orthopedic surgeon was Dr. Brett; other treating/examining providers included Dr. Denker and Dr. Lee.
- Key medical record points: imaging reports showed little progressive change over years; some treating notes suggested capability for modified work; later consultative/examining opinions were consistent with Dr. Brett.
- ALJ assessed a residual functional capacity (RFC) allowing medium work with additional limitations and gave weight to Dr. Brett’s opinions while discounting Drs. Denker and Lee.
- ALJ rejected portions of Sims’s subjective symptom testimony and gave germane reasons for discounting lay witness (spouse) testimony.
- Ninth Circuit reviews ALJ decisions for substantial evidence and legal error and affirmed the denial of benefits.
Issues
| Issue | Plaintiff's Argument | Defendant's Argument | Held |
|---|---|---|---|
| Whether ALJ implicitly rejected treating specialist Dr. Brett | Sims: ALJ’s RFC conflicts with Dr. Brett’s treating opinion | SSA: ALJ incorporated Dr. Brett’s limitations into RFC | Court: ALJ reasonably adopted and incorporated Dr. Brett’s opinion |
| Whether ALJ erred in rejecting opinions of Drs. Denker and Lee | Sims: ALJ should have favored Denker (2009) and Lee over Brett | SSA: ALJ gave specific, legitimate reasons supported by record to discount those opinions | Court: ALJ properly rejected Denker’s and Lee’s opinions due to inconsistencies with records and other exams |
| Whether ALJ improperly rejected Sims’s symptom testimony | Sims: ALJ improperly discounted his subjective pain and medication side effects | SSA: ALJ cited inconsistencies between testimony and objective medical evidence; accounted for medication effects where supported | Court: ALJ gave clear, convincing reasons (medical contradictions) and appropriately limited to supported effects |
| Whether ALJ improperly rejected lay witness testimony (spouse) | Sims: Spouse’s testimony corroborates limitations | SSA: Lay testimony inconsistent with medical and RFC findings | Court: ALJ provided germane reasons for rejecting spouse’s testimony (same reasons used to reject claimant’s testimony) |
Key Cases Cited
- Garrison v. Colvin, 759 F.3d 995 (9th Cir. 2014) (standard for reversing ALJ — decision must lack substantial evidence or contain legal error)
- Thomas v. Barnhart, 278 F.3d 947 (9th Cir. 2002) (ALJ must give specific and legitimate reasons to reject treating provider opinions)
- Ghanim v. Colvin, 763 F.3d 1154 (9th Cir. 2014) (conflict between treatment notes and provider opinions can justify discounting opinions)
- Brown-Hunter v. Colvin, 806 F.3d 487 (9th Cir. 2015) (ALJ must identify which testimony is not credible and give clear and convincing reasons)
- Carmickle v. Comm’r Soc. Sec. Admin., 533 F.3d 1155 (9th Cir. 2008) (contradiction with medical record is sufficient to reject subjective testimony)
- Bayliss v. Barnhart, 427 F.3d 1211 (9th Cir. 2005) (ALJ may account for only those symptom limitations supported by the record)
- Valentine v. Comm’r Soc. Sec. Admin., 574 F.3d 685 (9th Cir. 2009) (ALJ may reject lay witness testimony for germane reasons tied to claimant’s credibility)