Henry v. Commissioner Social Security AdministrationHenry v. Commissioner Social Security Administration
BECKERMAN, U.S. Magistrate Judge.
Thomas H.1 (Plaintiff) filed this appeal challenging the Commissioner of Social Security’s (Commissioner) denial of his applications for Disability Insurance Benefits (DIB) and Supplemental Security Income (SSI) under Titles II and XVI of the Social Security Act. The Court has jurisdiction pursuant to
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As with other agency decisions, federal court review of social security determinations is limited. Treichler v. Comm’r of Soc. Sec. Admin., 775 F.3d 1090, 1098 (9th Cir. 2014). A federal court’s review is limited because [f]or highly fact-intensive individualized determinations like a claimant’s entitlement to disability benefits, Congress places a premium upon agency expertise, and, for the sake of uniformity, it is usually better to minimize the opportunity for reviewing courts to substitute their discretion for that of the agency. Id. (quoting Consolo v. Fed. Mar. Comm’n, 383 U.S. 607, 621 (1966)). Adhering to this principle, courts follow three important rules in reviewing social security determinations. Brown-Hunter v. Colvin, 806 F.3d 487, 492 (9th Cir. 2015).
First, courts leave it to the [agency] to determine credibility, resolve conflicts in the testimony, and resolve ambiguities in the record. Id. (quoting Treichler, 775 F.3d at 1098). Second, courts will disturb the Commissioner’s decision to deny benefits only if it is not supported by substantial evidence or is based on legal error. Id. (quoting Treichler, 775 F.3d at 1098). Third, if the agency commits legal error, [courts] uphold the decision where that error is harmless, meaning that it is inconsequential to the ultimate nondisability determination, or that, despite the legal error, the agency’s path may reasonably be discerned, even if the agency explains its decision with less than ideal clarity. Id. (quoting Treichler, 775 F.3d at 1098); see also Smith v. Kijakazi, 14 F.4th 1108, 1111 (9th Cir. 2021) (And even where this modest [substantial evidence] burden is not met, [courts] will not reverse an [agency] decision where the error was harmless. (citing Molina v. Astrue, 674 F.3d 1104, 1111 (9th Cir. 2012), superseded on other grounds by regulation as recognized in Farlow v. Kijakazi, 53 F.4th 485, 487 (9th Cir. 2022)))).
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I. PLAINTIFF’S APPLICATIONS
Plaintiff was born in July 1983, making him thirty-seven years old on November 13, 2020, his alleged disability onset date. (Tr. 65, 112, 296.) Plaintiff is a high school graduate who has past relevant work experience as a housekeeping cleaner. (Id. at 31, 46, 59-61, 297.) In his applications, Plaintiff alleges disability due to depression, anxiety, obesity, left shoulder bursitis, bone spurs in his heels, planter fasciitis, high blood pressure, arthritis in his knees and upper back, and chronic pain and a herniated disc in his back, which makes his toes numb. (Id. at 66, 112.)
The Commissioner denied Plaintiff’s applications initially and upon reconsideration, and on March 22, 2024, Plaintiff requested a hearing before an Administrative Law Judge (ALJ). (Id. at 19.) On October 4, 2024, Plaintiff and an impartial vocational expert (VE) appeared and testified at a telephonic hearing held before an ALJ. (Id. at 43-64.) On October 25, 2024, the ALJ issued a written decision denying Plaintiff’s applications. (Id. at 19-34.) On July 10, 2025, the Appeals Council denied Plaintiff’s request for review, making the ALJ’s written decision the final decision of the Commissioner. (Id. at 1-6.) Plaintiff now seeks judicial review of that decision.
II. THE SEQUENTIAL PROCESS
A claimant is considered disabled if he or she is unable to engage in any substantial gainful activity by reason of any medically determinable physical or mental impairment which . . . has lasted or can be expected to last for a continuous period of not less than [twelve] months[.]
To establish a prima facie case of a disability, a claimant must demonstrate at steps one through four of the sequential evaluation process that she suffers from a severe impairment that prevents her from doing any work she has done in the past, or that she has a severe impairment and has no relevant past work[.] White v. Kijakazi, 44 F.4th 828, 833 (9th Cir. 2022) (citing Tackett v. Apfel, 180 F.3d 1094, 1098 (9th Cir. 1999)). If the claimant does so, [t]he burden then shifts to the Commissioner at step five to establish that the claimant can perform a significant number[] of jobs in the national economy given the claimant’s physical and mental limitations, age, education, and work experience. Id. (first quoting
III. THE ALJ’S DECISION
The ALJ applied the five-step sequential evaluation process to determine if Plaintiff is disabled. (Tr. 19-34.) At step one, the ALJ found that Plaintiff had not engaged in substantial gainful activity since November 13, 2020, his alleged disability onset date. (Id. at 21.) At step two, the ALJ determined that Plaintiff suffered from severe impairments: [L]umbar degenerative disc disease; obesity; left shoulder bursitis; left knee internal derangement; right metatarsophalangeal degenerative joint disease, calcaneal plantar spur, and great toe gout; depressive disorder; and anxiety disorder[.] (Id. at 22.) At step three, the ALJ found that
The ALJ then found that Plaintiff had the residual functional capacity (RFC) to perform light work, subject to the following limitations: (1) Plaintiff can lift, carry, push, and pull twenty pounds occasionally and ten pounds frequently, (2) Plaintiff can sit, stand, and walk about six hours in an eight-hour workday, (3) Plaintiff can occasionally stoop, crouch, kneel, reach overhead with his left upper extremity, and climb ramps and stairs, (4) Plaintiff can never crawl, balance (i.e., as defined by the Selective Characteristics of Occupations of the Dictionary of Occupational Titles), or climb ladders, ropes, and scaffolds, (5) Plaintiff can perform low stress work (i.e., no more than occasional changes in work setting and duties) that requires only an ability to understand, remember, and carry out simply tasks and instructions, and (6) Plaintiff cannot perform work that involves a moving conveyor belt, hourly quotas, moving mechanical parts, or unprotected heights. (Id. at 25.) At step four, the ALJ concluded that Plaintiff can perform his past work as a housekeeping cleaner. (Id. at 31-32.) At step five, the ALJ alternatively found that Plaintiff was not disabled because a significant number of jobs existed in the national economy that he could perform, such as a marker, cashier II, and routing clerk. (Id. at 32-33.)
DISCUSSION
In this appeal, Plaintiff argues that the ALJ erred by (1) failing to provide clear and convincing reasons for discounting his symptom testimony, (2) failing adequately to account for his morbid obesity in formulating his RFC, and (3) failing to provide a sufficient explanation for discounting the opinion of the consultative examiner, Linda Luther-Starbird, Ph.D. (Dr. Luther-Starbird). (Pl.’s Opening Br. at 2, ECF No. 11; Def.’s Br. at 2, ECF No. 13; Pl.’s Reply Br. at 1, 4-5, ECF No. 14.) As explained below, the Court finds that the ALJ’s decision is free of harmful
I. PLAINTIFF’S SYMPTOM TESTIMONY
A. Applicable Law
The Ninth Circuit has established a two-step analysis for determining the extent to which a claimant’s symptom testimony must be credited[.] Trevizo v. Berryhill, 871 F.3d 664, 678 (9th Cir. 2017). First, the ALJ must determine whether the claimant has presented objective medical evidence of an underlying impairment which could reasonably be expected to produce the pain or other symptoms alleged. Garrison v. Colvin, 759 F.3d 995, 1014 (9th Cir. 2014) (quoting Lingenfelter, 504 F.3d at 1035-36). Second, [i]f the claimant meets the first test and there is no evidence of malingering, the ALJ can only reject the claimant’s testimony about the severity of the symptoms if she gives specific, clear and convincing reasons for the rejection. Ghanim v. Colvin, 763 F.3d 1154, 1163 (9th Cir. 2014) (simplified).
B. Analysis
There is no evidence of malingering here and the ALJ determined that Plaintiff provided objective medical evidence of underlying impairments which might reasonably produce the symptoms alleged. (See Tr. 26, reflecting that the ALJ found that Plaintiff’s medically determinable impairments could reasonably be expected to cause some of the alleged symptoms). As a result, the ALJ was required to provide clear and convincing reasons for discounting Plaintiff’s symptom testimony. See Ghanim, 763 F.3d at 1163. The ALJ met that standard here.
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[T]he clear and convincing standard requires an ALJ to show his work[.] Smartt v. Kijakazi, 53 F.4th 489, 499 (9th Cir. 2022) (quoting Ahearn v. Saul, 988 F.3d 1111, 1117 (9th Cir. 2021)). That assure[s a] reviewing court that [the ALJ] did not arbitrarily discredit [the claimant’s] testimony. Cope v. Bisignano, No. 25-2337, 2026 WL 1134289, at *1 (9th Cir. Apr. 27, 2026) (simplified). Satisfying this standard turns on whether the ALJ’s rationale is clear enough that it has the power to convince, not on whether [the] court is convinced[.] Smartt, 53 F.4th at 499.
In evaluating the sufficiency of the ALJ’s rationale, a court may not second-guess an ALJ’s reasonable interpretation of a claimant’s testimony. Id. at 500 (first quoting Rollins v. Massanari, 261 F.3d 853, 857 (9th Cir. 2001); and then citing Thomas, 278 F.3d at 959); see also Treichler, 775 F.3d at 1098 ([Courts] leave it to the ALJ to determine credibility, resolve conflicts in the testimony, and resolve ambiguities in the record.) (simplified). A court must instead ask whether the ALJ’s rationale for discounting the claimant’s testimony is supported by substantial evidence in the record as a whole; that is, more than a mere scintilla of evidence, which is not [a] high evidentiary threshold and such relevant evidence as a reasonable mind might accept as adequate to support a conclusion. Ahearn, 988 F.3d at 1115 (quoting Biestek v. Berryhill, 587 U.S. 97, 103 (2019)); cf. Chen v. Bisignano, No. 25-3588, 2026 WL 1427028, at *1-2 (9th Cir. May 21, 2026) (Substantial evidence requires more than a mere scintilla of evidence but does not require more than such relevant evidence as a reasonable mind might accept as adequate to support a conclusion when considering the entire record. . . . The ample record evidence relied on by the ALJ is more than a mere scintilla of evidence to support his decision to discount [the claimant’s] subjective symptom testimony. (quoting Biestek, 587 U.S. at 103)).
Specifically, the ALJ explained that despite conflicting evidence, including medical opinions that she found generally or partially persuasive, her RFC determination included some addition[al] restrictions that account[ed] for Plaintiff’s reports of varying levels of depression, anxiety, and [physical] discomfort. (Tr. 31.) For example, the ALJ explained that her RFC accounted for Plaintiff’s most regularly reported difficulties of impaired attention and stress management by limiting him to simple instructions and tasks and low stress work (defined as requiring only occasional changes in work setting and duties, no work on a moving conveyor belt and no work requiring hourly quotas). (Id.) Further, the ALJ, seeking to avoid additional stress on the affected joints that could aggravate discomfort or aggravation of the left shoulder impairment, formulated an RFC that precluded crawling, balancing, and climbing of ladders, ropes, or scaffolds and more than occasional overhead reaching with the left arm. (Id. at 29.)
2. Reported Activities
To the extent the ALJ declined fully to credit Plaintiff’s symptom testimony, the Court finds that the ALJ provided clear and convincing reasons, supported by substantial evidence, for doing so.
It is well established that an ALJ may discount a claimant’s symptom testimony based in part on an inconsistency between his claimed limitations and reported activities. In Burrell v. Colvin, 775 F.3d 1133, 1137-38 (9th Cir. 2014), the Ninth Circuit confirmed as much, noting that [i]nconsistencies between a claimant’s testimony and the claimant’s reported activities provide a valid reason for an adverse credibility determination. Id. (citing Light v. Soc. Sec. Admin., 119 F.3d 789, 792 (9th Cir. 1997)); see also Garrison, 759 F.3d at 1016 (stating that if a claimant’s level of activity is inconsistent with [his] claimed limitations, an ALJ may discount the claimant’s testimony based on his reported activities) (simplified); Ghanim, 763 F.3d at 1165 (Engaging in daily activities that are incompatible with the severity of symptoms alleged can support an adverse credibility determination. (first citing Orn v. Astrue, 495 F.3d 625, 639 (9th Cir. 2007);
The ALJ here discounted Plaintiff’s testimony on the ground that he reported engaging in activities (e.g., working, cutting wood, and laborious outdoor activity) that were indicative of the ability to stand and walk much more than his stated limits in function reports and hearing testimony (i.e., his reported inability to stand for more than five minutes at time or lift more than ten pounds). (Tr. 26, citing Ex. 12D, Ex. 4F at 19, 21, 27, Ex. 5F at 7-8, Ex. 7F at 10-1, i.e., Tr. 279-85, 699, 701, 707, 777-78, 849-54.) The ALJ also explained that she found Plaintiff’s reports about working on art projects and playing guitar undermine[d] his complaints regarding upper extremity limitations and focus. (Id., citing Ex. 4F at 6-8, 18-19, 31, 38, 41, Ex. 14F at 21, i.e., Tr. 686-88, 698-99, 711, 717, 721, 968.) Further, the ALJ explained that Plaintiff minimized his performance of household chores at the administrative hearing, yet he reported to multiple sources that he was independent in a variety of tasks including cooking and cleaning. (Id., citing Ex. 4F at 7-8, Ex. 8F at 4, Ex. 9F at 8-9, Ex. 18F at 4, i.e., Tr. 687-88, 921, 936-37, 1003.)
Plaintiff acknowledges that the ALJ discounted his testimony based in part on his self-reported activities. (Pl.’s Opening Br. at 7, 10, citing Tr. 25-31.) Plaintiff, however, argues that the ALJ’s reasons were neither clear and convincing nor supported by substantial evidence. (Id. at 7.)
With respect to his reported activities, Plaintiff argues that although he reported engaging in the activities upon which the ALJ relied, his description of those activities was not inconsistent with his allegations and does not necessarily translate to an ability to perform full-time work compatible with the ALJ’s RFC determination. (Id. at 10, citing Tr. 25.) In support,
Plaintiff offers a different interpretation of the record that tend[s] to corroborate [his]testimony[, b]ut simply offering an alternative interpretation of the record does not demonstrate the ALJ committed reversible error. Jarrett v. O’Malley, No. 23-3565, 2024 WL 4707890, at *1 (9th Cir. Nov. 7, 2024) (first citing Smartt, 53 F.4th at 494; and then citing Carmickle v. Comm’r, Soc. Sec. Admin., 533 F.3d 1155, 1164 (9th Cir. 2008)). After all, [w]here the [record] evidence is susceptible to more than one rational interpretation, the ALJ’s decision must be affirmed. Smartt, 53 F.4th at 494 (quoting Vasquez v. Astrue, 572 F.3d 586, 591 (9th Cir. 2009)); see also Hougas v. Bisignano, No. 24-5650, 2025 WL 2964997, at *2 (9th Cir. Oct. 21, 2025) (affirming the ALJ’s decision because the claimant offer[ed] an interpretation of the record evidence that support[ed] his subjective complaints—but [did] not undermine the ALJ’s
The Ninth Circuit’s decision in Berry v. Astrue, 622 F.3d 1228, 1234-35 (9th Cir. 2010), is illustrative of this principle. In that case, the Ninth Circuit reviewed an ALJ’s discounting of a claimant’s testimony based on contradictions between complaints in [his] . . . activity questionnaire and hearing testimony and some of his other self-reported activities. Id. at 1234. The Ninth Circuit noted that [o]n the one hand, some of [the claimant’s] statements supported his hearing testimony and portions of his activity questionnaire, but [o]n the other hand, some of [his] other self-reported activities and self-evaluations suggested a higher degree of functionality. Id. at 1234-35. Although the record was susceptible to more than one rational interpretation, the Ninth Circuit upheld the ALJ’s decision because it agree[d] that the record support[ed] . . . and justif[ied the ALJ’s] decision to discount some of [the claimant’s] subjective complaints. Id. at 1235 (citing Bray v. Comm’r of Soc. Sec. Admin., 554 F.3d 1219, 1227 (9th Cir. 2009)).
Similarly here, Plaintiff advances an alternative interpretation of the record that is rational, but substantial evidence nevertheless supports the ALJ’s partial discounting of his testimony because he reported engaging in activities incompatible with his allegations of debilitating pain. See Chen, 2026 WL 1427028, at *1-2 (holding that the ALJ satisfied the clear and convincing reasons standard, as more than a mere scintilla of evidence . . . support[ed the ALJ’s] decision to discount [the claimant’s] subjective symptom testimony (quoting Biestek, 587 U.S. at 103)).
Consider some of the reports that Plaintiff’s treating provider documented in his medical records. For example, in treatment notes dated September 25, 2020 and April 2, 2021, less than
Now consider some of Plaintiff’s testimony and reports about the alleged severity of his symptoms. Plaintiff completed adult function reports on August 19, 2021, February 8, 2023, and January 8, 2024, in which he reported that (1) he used to work full time, explore the woods, split wood, [perform] chores, hunt[, and] fish but he was no longer able to do so because of his illnesses, injuries, or conditions, (2) he is in excruciating pain every day with no relief and his pain never goes below a [nine] on a scale of [one to ten], and (3) he can only lift [five] to [ten] pounds and not repetitively. (Id. at 321, 327, 362, 366-67.) Further, at the October 4, 2024 hearing, Plaintiff testified that he must find a place to sit down or leave a store after five minutes of standing because his legs start getting weak and feel[] like they [cannot] support [him], and it causes excruciating pain. (Tr. 52-53; cf. id. at 707, Plaintiff was able to navigate
On this record, the Court finds that Plaintiff fails to demonstrate that the ALJ committed reversible error in partially discounting his testimony because his self-reported activities suggested that his symptoms were not as debilitating as he alleged. (See Pl.’s Opening Br. at 4-12; Pl.’s Reply Br. at 1-4.) Where, as here, the record is susceptible to more than one rational interpretation, the Court must uphold the ALJ’s conclusion. See Ford, 950 F.3d at 1154 (If the evidence is susceptible to more than one rational interpretation, it is the ALJ’s conclusion that must be upheld.) (simplified); cf. Jarrett, 2024 WL 4707890, at *1 ([S]imply offering an alternative interpretation of the record does not demonstrate the ALJ committed reversible error.) (citations omitted); Smartt, 53 F.4th at 499-500 (The ALJ made a reasonable determination based on specific, clear, and convincing evidence that [the claimant’s] activities
3. Treatment History
The ALJ also discounted Plaintiff’s testimony based in part on significant gaps in his treatment history. (See id. at 26, indicating that the ALJ discounted Plaintiff’s statements about the intensity, persistence, and limiting effects of his symptoms and in doing so began with the objective evidence, including examinations and diagnostic studies before turning to Plaintiff’s self-reported activities and failure to engage in treatment for his back or mental health for several years).
Clear and convincing reasons for discounting a claimant’s testimony include significant gaps in treatment. Wood v. Bisignano, No. 24-6838, 2025 WL 3527450, at *2 (9th Cir. Dec. 9, 2025). For example, in Wood, the Ninth Circuit explained that because the ALJ did not find evidence of malingering and determined that objective medical evidence established an impairment that could produce the symptoms of which the claimant complained, the ALJ [needed to] offer clear and convincing reasons for rejecting the claimant’s testimony. Id. (citing Smartt, 53 F.4th at 497). The Ninth Circuit held that the ALJ did just that and thus did not improperly discount [the claimant’s] testimony. Id. In support of this holding, the Ninth Circuit explained that the ALJ identified inconsistencies between [the claimant’s] testimony and the medical evidence in the record and observed that there were significant gaps in treatment and an improvement in [the claimant’s] mental health and that [t]hese reasons [were] sufficiently clear and convincing. Id. (citing Smartt, 53 F.4th at 497-501); see also Thomas v. Saul, 830 F. App’x 196, 198 (9th Cir. 2020) (The ALJ also pointed to [the claimant’s] improvement during treatment and lengthy gaps in treatment that suggest that his mental impairments were not as
In his opening brief, Plaintiff failed timely to raise any challenge to the ALJ’s reliance on gaps in his treatment history. (See Pl.’s Opening Br. at 4-12.) The Commissioner, however, argued that the ALJ discounted Plaintiff’s testimony based on such gaps. (See Def.’s Br. at 6-7, arguing that the ALJ appropriately found that Plaintiff’s allegation of debilitating pain was inconsistent with his treatment history and focusing on Plaintiff’s failure to seek any treatment for his allegedly most limiting impairment involving the back for several years (citing Tr. 26-27)). The Commissioner also argued that Plaintiff forfeited any argument to the contrary. (Id. at 7, citing Nadon v. Bisignano, 145 F.4th 1133, 1138 (9th Cir. 2025)); see also Nadon, 145 F.4th at 1138 (noting that the ALJ provided other reasons for discounting the various healthcare professionals’ opinions and holding that [b]ecause [the claimant] failed to . . . challenge the ALJ’s reliance on them, the Commissioner was correct to assert that [the claimant] forfeited the argument).
Responding to the Commissioner’s arguments, Plaintiff asserts that the Commissioner impermissibly attempts to offer post hoc rationalizations for the ALJ’s decision and that the ALJ made no such finding regarding any gaps in his back treatment history. (Pl.’s Reply Br. at 3.) Plaintiff also argues that the portion of the decision cited by the Commissioner states only that [he] ‘did not seek treatment specific to the knees during the period at issue.’ (Id., quoting Tr. 27.)
The Court finds Plaintiff’s arguments unpersuasive. Long-standing principles of administrative law require [a federal court] to review the ALJ’s decision based on the reasoning and factual findings offered by the ALJ—not post hoc rationalizations that attempt to intuit what
In seeking to avoid the Commissioner’s forfeiture argument, Plaintiff invokes Bray and principles of administrative law that do not apply under the circumstances presented here. At the same time, Plaintiff does not challenge or address the ALJ’s reliance on significant gaps in his mental health treatment. (Compare Pl.’s Reply Br. at 1-4, and Tr. 26); see also Anderson v. Colvin, 223 F. Supp. 3d 1108, 1131 (D. Or. 2016) ([The p]laintiff raises for the first time in her reply brief that contrary to the regulations, the ALJ failed to [consider] her age and time out of the workforce when determining her RFC. This argument was not, however, properly presented because all issues must be raised in the initial brief. Accordingly, it will not be considered.) (simplified); Johnson v. Colvin, No. 13-cv-01139-HZ, 2014 WL 3851140, at *5 n.2 (D. Or. Aug. 1, 2014) (Because [the p]laintiff failed to raise the error in his opening brief, the error is waived.).
Plaintiff’s failure to do so is noteworthy, including because the ALJ later made other related findings. (See Tr. 28, Based on this improvement, [Plaintiff] and [his] therapist agreed to close the session of care. . . . [The therapist] provided [Plaintiff with] recommendations for community-based therapists and offered [him] ‘continuing care with th[e] writer to support successful transfer’ elsewhere if needed. . . . [Plaintiff] did not establish with another therapist and did not seek additional help with a transfer. At follow up with a provider several months later, [Plaintiff] did not raise concerns about mental health and the Patient Health Questionnaire
Given Plaintiff’s failure timely and completely to challenge the ALJ’s reliance on his significant treatment gaps or adequately respond to the Commissioner’s arguments, the Court finds that the ALJ appropriately discounted Plaintiff’s testimony based in part on his treatment history. See Cody v. Bisignano, No. 25-3837, 2026 WL 1470573, at *2 (9th Cir. May 26, 2026) (holding that the ALJ appropriately discounted [the claimant’s symptom] testimony in part because the record indicated that [the claimant] sought minimal treatment for mental health limitations).
4. Plaintiff’s Use of an Assistive Device
In evaluating Plaintiff’s symptom testimony, the ALJ also found that record evidence did not support Plaintiff’s need to use an assistance device[,] as [he] reported elsewhere. (Tr. 27, citing Ex. 4E at 7, Ex. 11E, Ex. 18F, and Plaintiff’s [h]earing testimony, i.e., Tr. 41-64, 304-18, 362-69, 1000-10; see also Tr. 920-21, 923, 1002-03, 1005, noting that Plaintiff attended consultative physical exams using a single point wooden cane, reported that he continue[d] to use [it] . . . daily to help him with balance and coordination because occasionally his legs will just ‘give out from under him,’ estimated that he fall[s] about [one to two times] per week, and utilized the cane during the nurse practitioner’s testing; id. at 49-50, reflecting that during the
The ALJ appropriately found that Plaintiff’s cane usage undermined his symptom testimony. See Bostwick v. Berryhill, 677 F. App’x 344, 345 (9th Cir. 2017) (holding that the ALJ did not err in determining that the claimant’s symptom testimony was inconsistent with the lack of evidence that she needed a hand-held assistive device to walk) (citation omitted); see also Smartt, 53 F.4th at 497 (holding that the claimant’s inconsistent use of mobility aids belie[d] her testimony about the severity of her limitations and explaining that [t]he ALJ identified multiple specific examples of [the claimant’s] inconsistent use of mobility aids contrary to her testimony about the extent of her limitations.). Plaintiff does not present any argument to the contrary. (See Pl.’s Opening Br. at 4-12; Pl.’s Reply Br. at 1-4; cf. Def.’s Br. at 7, relying on this portion of the ALJ’s decision).
5. Conflicting Medical Evidence
Plaintiff argues that the ALJ erred in discounting his testimony based on conflicting medical evidence. (See Pl.’s Opening Br. at 4-12; Pl.’s Reply Br. at 1-4; cf. Def.’s Br. at 8-10; Tr. 26-28.)
Contradictory medical evidence is a clear and convincing reason for declining fully to credit a claimant’s symptom testimony. See Smartt, 53 F.4th at 496-97, 499 (holding that the ALJ properly discounted [the claimant’s] subjective [symptom] testimony and self-reported limitations[, in part] because . . . the objective medical evidence was inconsistent with those limitations and explaining that [c]ontradiction with the medical record is a sufficient basis for rejecting the claimant’s subjective testimony (quoting Carmickle, 533 F.3d at 1161)). In this case, the Court finds it unnecessary to resolve the parties’ dispute regarding the ALJ’s reliance on conflicting medical evidence because Plaintiff’s self-reported activities, treatment gaps, and cane
6. Conclusion
In sum, the ALJ did not commit reversible error in discounting Plaintiff’s testimony.4 See Brokaw v. Bisignano, No. 24-6710, 2025 WL 3158801, at *2 (9th Cir. Nov. 12, 2025) (Because the ALJ’s rationale is clear enough that it has the power to convince, the ALJ’s citation of [conflicting] medical records and . . . activities provided sufficiently specific, clear, and convincing reasons for discounting her subjective testimony . . . [about her] impairments.) (simplified).
II. MEDICAL OPINION EVIDENCE
A. Applicable Law
In January 2017, the Social Security Administration issued revised regulations for evaluating medical opinions relating to claims filed on or after March 27, 2017.5 Cross v. O’Malley, 89 F.4th 1211, 1214 (9th Cir. 2024) (citing Revisions to Rules Regarding the Evaluation of Medical Evidence, 82 Fed. Reg. 5844-01 (Jan. 18, 2017) (codified at
Specifically, the revised regulations require an ALJ to discuss the supportability and consistency of medical evidence—the factors the agency has historically found to be the most important in evaluating medical opinions—while allowing for discussion of other factors listed in paragraphs (c)(3) through (c)(5), as appropriate. Id. at 1215 (citing
In addition to supportability and consistency, [a]n ALJ may discuss other factors [listed in paragraphs (c)(3) through (c)(5)], such as the medical source’s ‘relationship with the claimant’ or ‘specialization,’ but generally has no obligation to do so. Cross, 89 F.4th at 1214 (citing
Where, as here, the new regulations apply, a district court reviews the ALJ’s evaluation of a medical opinion for substantial evidence. See Woods, 32 F.4th at 787 (For claims subject to the new regulations, . . . an ALJ’s decision, including the decision to discredit any medical opinion, must simply be supported by substantial evidence.); id. at 792 (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.); Metcalf v. Kijakazi, No. 22-35201, 2022 WL 17592194, at *1 (9th Cir. Dec. 13, 2022) (observing that under the revised regulations . . . , the ALJ’s evaluation of a medical opinion is reviewed for substantial evidence (citing Woods, 32 F.4th at 789)); see also Stiffler, 102 F.4th at 1108 (In sum, the ALJ’s evaluation of [the physician’s] medical opinion is supported by substantial evidence.).
B. Analysis
Plaintiff argues that substantial evidence does not support the ALJ’s evaluation of the opinion of the consultative examiner, Dr. Luther-Starbird. (Pl.’s Opening Br. at 2, 15-19.) The Court disagrees.
1. Dr. Luther-Starbird’s Opinion
On February 24, 2024, Oregon’s Disability Determination Services (DDS) referred Plaintiff to Dr. Luther-Starbird for a consultative psychological assessment. (Tr. 991-997.) Dr. Luther-Starbird’s assessment consisted of a mental status exam, clinical interview and observations, and review of records that she received from DDS—namely, a consultative psychological evaluation that Ezekiel Sanders, Psy.D. (Dr. Sanders) conducted on April 22, 2023. (See id. at 991, citing Plaintiff’s Olympus Health evaluation dated April 22, 2023; id. at
During the clinical interview, Plaintiff reported that he is unable to bend or reach because of his chronic pain, he has crushed discs in his back just above [the] pelvis and fears falling and does not want to go out, his depression and anxiety respectively began in 2012 and after injuring his back, his mental health issues make it very difficult to deal with people, and his depression can rise up to a ten on a ten-point scale and cause him to consider[] suicide, but [he] has reached out to others instead. (Id. at 992.) Plaintiff added that he uses marijuana, his therapy was [h]elpful but the counselor terminated [it] . . . for reasons unknown to him as he wanted to continue, he tries to take care of the house, do chores, and cook for his nephews when his sister is at work, he sometimes works on art projects to keep busy, he wakes up [early] and performs all activities of daily living with assistance, when his nephews are available to help, he drives and does not need help making purchases, he has positive relationships and interacts with his sister and nephews, and he does not interact with friends [or have a] social group. (Id. at 992-93.)
Dr. Luther-Starbird’s diagnoses were mild to moderate major depressive disorder, generalized anxiety disorder, social anxiety disorder, chronic pain, and per [Plaintiff’s] reports, a herniated disc, arthritis, bursitis, bone spurs, and plantar fasciitis. (Id. at 995.) In terms of work-related functional limitations, Dr. Luther-Starbird opined that Plaintiff suffers from (1) mild to moderate limitations in understanding, remembering, or applying information, which may result in his efficiency . . . wax[ing] and wan[ing] depending on his level of pain and depression, (2) marked limitations in his ability to interact with others, in large part because of his social anxiety, depression, isolation, failure to reach out to or form relationships with others, and
2. Disposition
The Court concludes that contrary to Plaintiff’s argument, substantial evidence supports the ALJ’s evaluation and discounting of Dr. Luther-Starbird’s opinion. See Ahearn, 988 F.3d at 1115 ([T]he threshold for [substantial] evidentiary sufficiency is not high. Substantial evidence . . . is more than a mere scintilla. It means—and means only—such relevant evidence as a reasonable mind might accept as adequate to support a conclusion. (quoting Biestek, 587 U.S. at 103)).
Under the revised regulations, an ALJ must articulate how persuasive [he] finds all of the medical opinions from each doctor or other source, and explain how [he] considered the supportability and consistency factors in reaching these findings. Stiffler, 102 F.4th at 1106 (quoting Woods, 32 F.4th at 792). Consistency concerns the extent to which a medical opinion is consistent with the evidence from other medical and nonmedical sources, Kitchen, 82 F.4th at 740 (quoting Woods, 32 F.4th at 792), and [s]upportability focuses on whether ‘a medical source supports a medical opinion by explaining the relevant objective medical evidence.’ Id. at 1106 (quoting Woods, 32 F.4th at 791-92); cf. Kitchen, 82 F.4th at 740 (Supportability
In this case, the ALJ addressed consistency . . . by reviewing the opinions of the other medical professionals—none of whom reached the same conclusion or identified the same degree of limitation as Dr. Luther-Starbird. See Morrow, 2025 WL 1924900, at *1 (upholding a similar finding); (cf. Tr. 31, finding that Dr. Luther-Starbird’s opinion regarding the degree of limitation attributable to Plaintiff’s mental impairments was inconsistent with the state agency findings, which the ALJ detailed beforehand; see also id. at 30, describing the state agency psychological consultants’ findings and stating that the state agency consultant’s opinion on reconsideration was generally persuasive (citing Exs. 1A, 2A, 6A, 7A, i.e., Tr. 65-108, 112-33)).
Plaintiff fails adequately to address the ALJ’s reliance on the reviewing state agency psychological consultant. Plaintiff acknowledges that the ALJ found Dr. Luther-Starbird’s opinions inconsistent with the overall record. (Pl.’s Opening Br. at 18.) To the extent the ALJ evaluated the consistency between Dr. Luther-Starbird’s findings and other medical opinions, Plaintiff argues only that Dr. Luther-Starbird’s opinion is consistent with Dr. Sanders’ opinion. (Id. at 18-19.)
Plaintiff fails to demonstrate that the ALJ committed reversible error. The ALJ found that some of Dr. Sanders’ findings were persuasive but otherwise deferred to and resolved any conflicts in favor of the state agency psychological consultant’s more restrictive finding on reconsideration.7 (See id. at 30, reflecting that the ALJ explained that Dr. Sanders’ opinions were
Also noteworthy is that in addition to assigning Plaintiff a score of twenty-six out of thirty on a Mini Mental Status Exam (MMSE), Dr. Sanders opined that Plaintiff’s depression and inattention . . . contribut[e] to his overall challenges but do not limit him from being able to work. (Tr. 940); see generally Battle v. Astrue, 243 F. App’x 514, 517 (11th Cir. 2007) (noting that a claimant scored [twenty-six] out of [thirty on the MMSE], placing him in the mildly impaired range); see also Decker v. Colvin, No. 6:11-cv-06344-HU, 2013 WL 3791444, at *15 (D. Or. July 19, 2013) (making a similar observation about an MMSE score and citing Battle in support).
Plaintiff fails to demonstrate that the ALJ erred in resolving conflicts in the medical opinion evidence because he does not address these findings, which do not support Dr. Luther-Starbird’s opinions or the alleged severity of his symptoms. See Diedrich v. Berryhill, 874 F.3d 634, 638 (9th Cir. 2017) (The ALJ is responsible for studying the record and resolving any conflicts or ambiguities in it) (citation omitted); see also Slayton v. O’Malley, No. 22-16883, 2024 WL 637482, at *1 (9th Cir. Feb. 15, 2024) (The ALJ ‘is charged with determining credibility and resolving . . . conflict[s]’ between medical evidence. (quoting Chaudhry v. Astrue, 688 F.3d 661, 671 (9th Cir. 2012))).
Plaintiff merely argues that the ALJ did not rely on Dr. Sanders’ opinion in rejecting Dr. Luther-Starbird’s opinion, that the Commissioner’s suggestion to the contrary amounts to a
extent it supported that Plaintiff’s mental health impairments/limitations were not disabling. (Tr. 30.)
The ALJ also found Dr. Luther-Starbird’s opinion unpersuasive because she offered little to no support for any of the limitations that she identified, and because her opinion was incompatible with records capturing periods and instances in which Plaintiff was not engaged in treatment for mental health and deni[ed] or did not endorse[] such symptoms. (Tr. 31; cf. id. at 991, noting that Dr. Luther-Starbird’s record review was limited to Dr. Sanders’ eleven-page report). The ALJ in turn found that Dr. Luther-Starbird appear[ed] to rel[y] primarily on subjective complaints (id.), which, as discussed above, the ALJ declined fully to credit.
[A]n ALJ may give less weight to a mental health opinion when it relies ‘more heavily’ on self-reports than on clinical observations, particularly when the ALJ properly discounts the
The Court concludes that the ALJ adequately considered the supportability factor. Notably, Drs. Luther-Starbird’s and Sanders’ consultative psychological exams were based on a clinical interview, a single previous assessment that they received from DDS, and mental status exams consisting of common components. (Compare Tr. 931-43, and id. at 991-97.) Even if Dr. Sanders failed to express his findings in comparable ways, this does not detract from the ALJ’s finding that Dr. Luther-Starbird appeared to rely primarily (not solely) on Plaintiff’s self-reports. (See Pl.’s Reply Br. at 7, making this same claim about Dr. Sanders’s nearly identical consultative exam). Thus, substantial evidence supports the ALJ’s evaluation of Dr. Luther-Starbird’s opinion.
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For the reasons stated, Court AFFIRMS the Commissioner’s decision because it is free of harmful legal error and supported by substantial evidence in the record.
IT IS SO ORDERED.
DATED this 20th day of July, 2026.
HON. STACIE F. BECKERMAN
United States Magistrate Judge