(SS) Hanson v. Commissioner of Social Security ( 2023 )

UNITED STATES DISTRICT COURT 2 EASTERN DISTRICT OF CALIFORNIA 3 4 MARTIN JUSTIN (AMY) HANSON No. 1:21-cv-00610-GSA 5 Plaintiff, 6 v. OPINION & ORDER DIRECTING ENTRY 7 OF JUDGMENT IN FAVOR OF KILOLO KIJAKAZI, acting DEFENDANT COMMISSIONER OF 8 Commissioner of Social Security, SOCIAL SECURITY AND AGAINST PLAINTIFF 9 Defendant. (Doc. 16, 18) 10 11 12 I. Introduction 13 Plaintiff Martin Justin (Amy) Hanson (“Plaintiff”) seeks judicial review of a final decision 14 of the Commissioner of Social Security (“Commissioner” or “Defendant”) denying her application 15 for supplemental security income pursuant to Title XVI of the Social Security Act. The matter is 16 before the Court on the parties’ briefs which were submitted without oral argument to the United 17 States Magistrate Judge.1 Docs. 16, 18. After reviewing the record the Court finds that substantial 18 evidence and applicable law support the ALJ’s decision. Plaintiff’s appeal is therefore denied. 19 II. Factual and Procedural Background2 20 On January 28, 2019 Plaintiff applied for supplemental security income. The application 21 was denied initially on May 9, 2019 and on reconsideration on August 26, 2019. Plaintiff requested 22 a hearing which was held before an Administrative Law Judge (the “ALJ”) on October 7, 2020. 23 AR 33–63. On October 30, 2020 the ALJ issued a decision denying Plaintiff’s application. AR 24 15–29. The Appeals Council denied review on March 3, 2021. AR 1–6. On April 12, 2021, 25 Plaintiff filed a complaint in this Court. 26 27 1 The parties consented to the jurisdiction of a United States Magistrate Judge. See Docs. 6 and 10. 2 The Court has reviewed the relevant portions of the administrative record including the medical, opinion and 28 testimonial evidence about which the parties are well informed, which will not be exhaustively summarized. Relevant portions will be referenced in the course of the analysis below when relevant to the parties’ arguments. III. The Disability Standard 2 Pursuant to 42 U.S.C. §405(g), this court has the authority to review a decision by the 3 Commissioner denying a claimant disability benefits. “This court may set aside the 4 Commissioner’s denial of disability insurance benefits when the ALJ’s findings are based on legal 5 error or are not supported by substantial evidence in the record as a whole.” Tackett v. Apfel, 180 6 F.3d 1094, 1097 (9th Cir. 1999) (citations omitted). Substantial evidence is evidence within the 7 record that could lead a reasonable mind to accept a conclusion regarding disability status. See 8 Richardson v. Perales, 402 U.S. 389, 401 (1971). It is more than a scintilla, but less than a 9 preponderance. See Saelee v. Chater, 94 F.3d 520, 522 (9th Cir. 1996) (internal citation omitted). 10 When performing this analysis, the court must “consider the entire record as a whole and 11 may not affirm simply by isolating a specific quantum of supporting evidence.” Robbins v. Social 12 Security Admin., 466 F.3d 880, 882 (9th Cir. 2006) (citations and quotations omitted). If the 13 evidence could reasonably support two conclusions, the court “may not substitute its judgment for 14 that of the Commissioner” and must affirm the decision. Jamerson v. Chater, 112 F.3d 1064, 1066 15 (9th Cir. 1997) (citation omitted). “[T]he court will not reverse an ALJ’s decision for harmless 16 error, which exists when it is clear from the record that the ALJ’s error was inconsequential to the 17 ultimate non-disability determination.” Tommasetti v. Astrue, 533 F.3d 1035, 1038 (9th Cir. 2008). 18 To qualify for benefits under the Social Security Act, a plaintiff must establish that 19 he or she is unable to engage in substantial gainful activity due to a medically determinable physical or mental impairment that has lasted or can be expected to 20 last for a continuous period of not less than twelve months. 42 U.S.C. § 21 1382c(a)(3)(A). An individual shall be considered to have a disability only if . . . his physical or mental impairment or impairments are of such severity that he is not 22 only unable to do his previous work, but cannot, considering his age, education, and work experience, engage in any other kind of substantial gainful work which exists 23 in the national economy, regardless of whether such work exists in the immediate area in which he lives, or whether a specific job vacancy exists for him, or whether 24 he would be hired if he applied for work. 25 42 U.S.C. §1382c(a)(3)(B). 26 To achieve uniformity in the decision-making process, the Commissioner has established a 27 sequential five-step process for evaluating a claimant’s alleged disability. 20 C.F.R. §§ 416.920(a)- 28 (f). The ALJ proceeds through the steps and stops upon reaching a dispositive finding that the claimant is or is not disabled. 20 C.F.R. §§ 416.927, 416.929. 2 Specifically, the ALJ is required to determine: (1) whether a claimant engaged in substantial 3 gainful activity during the period of alleged disability, (2) whether the claimant had medically 4 determinable “severe impairments,” (3) whether these impairments meet or are medically 5 equivalent to one of the listed impairments set forth in 20 C.F.R. § 404, Subpart P, Appendix 1, (4) 6 whether the claimant retained the residual functional capacity (“RFC”) to perform past relevant 7 work, and (5) whether the claimant had the ability to perform other jobs existing in significant 8 numbers at the national and regional level. 20 C.F.R. § 416.920(a)-(f). While the Plaintiff bears 9 the burden of proof at steps one through four, the burden shifts to the commissioner at step five to 10 prove that Plaintiff can perform other work in the national economy given her RFC, age, education 11 and work experience. Garrison v. Colvin, 759 F.3d 995, 1011 (9th Cir. 2014). 12 IV. The ALJ’s Decision 13 At step one the ALJ found that Plaintiff had not engaged in substantial gainful activity since 14 her application date of January 28, 2019. AR 17. At step two the ALJ found that Plaintiff had the 15 following severe impairments: obesity, major depressive disorder, generalized anxiety disorder, 16 and gender dysphoria. AR 17–19. The ALJ also found at step two that Plaintiff had the following 17 non-severe, or non-medically determinable impairments: headaches, liver problems, 18 gastroesophageal reflux disease (GERD), flat feet, vision problems, knee pain, back pain, sleep 19 apnea, and hearing problems, At step three the ALJ found that Plaintiff did not have an impairment 20 or combination thereof that met or medically equaled the severity of one of the impairments listed 21 in 20 C.F.R. Part 404, Subpart P, Appendix 1. AR 19–22. 22 Prior to step four the ALJ evaluated Plaintiff’s residual functional capacity (RFC) and 23 concluded that Plaintiff had the RFC to perform light work as defined in 20 C.F.R. 416.967(b) with 24 the following additions: can stand and walk 4 out of 8 hours; sit 6 out of 8 hours; occasionally 25 stoop, kneel, crouch, crawl, and climb; perform simple, routine tasks that can be mastered in 30 26 days or less; work in proximity to others; occasionally interact with supervisors, coworkers, and 27 the general public; maintain concentration, persistence, and pace within customary norms; make 28 simple work-related decisions; can plan and set goals; adapt to routine workplace changes; can travel; and, can recognize and avoid ordinary workplace hazards. AR 22–27. 2 At step four the ALJ found that Plaintiff had no past relevant work. AR 28. At step five 3 the ALJ found that Plaintiff could perform jobs existing in significant numbers in the national 4 economy, namely: small products/bench assembler; marker; storage facility rental clerk. AR 29. 5 Accordingly, the ALJ found that Plaintiff was not disabled at any time since her application date 6 of January 28, 2019. AR 29. 7 V. Issues Presented 8 Plaintiff does not formally assert any specific issues by way of section headings, nor a 9 statement of issues presented, or otherwise. Plaintiff’s argument generally concerns the RFC, the 10 opinion evidence, and Plaintiff’s testimony. 11 A. Applicable Law 12 At step two of the five-step process, plaintiff has the burden to provide evidence of a 13 14 medically determinable physical or mental impairment that is severe and that has lasted or can be 15 expected to last for a continuous period of at least twelve months. Ukolov v. Barnhart, 420 F.3d 16 1002, 1004–05 (9th Cir. 2005) (citing 42 U.S.C. § 423(d)(1)(A)). A medically determinable 17 physical or mental impairment “must result from anatomical, physiological, or psychological 18 abnormalities that can be shown by medically acceptable clinical and laboratory diagnostic 19 techniques,” and will not be found based solely on the claimant’s statement of symptoms, a 20 diagnosis or a medical opinion. 20 C.F.R. § 404.1521. 21 22 Step two is “a de minimis screening device [used] to dispose of groundless claims.” Smolen 23 v. Chater, 80 F.3d 1273, 1290 (9th Cir. 1996). A “severe” impairment or combination of 24 impairments is one that significantly limits physical or mental ability to do basic work activities. 25 20 C.F.R. § 404.1520. An impairment or combination of impairments should be found to be “non- 26 severe” only when the evidence establishes merely a slight abnormality that has no more than a 27 minimal effect on an individual’s physical or mental ability to do basic work activities. Webb v. 28 Barnhart, 433 F.3d 683, 686 (9th Cir. 2005); 20 C.F.R. §§ 404.1522, 416.922. “Basic work 2 activities” mean the abilities and aptitudes necessary to do most jobs, including physical functions 3 such as walking, standing, sitting, lifting, pushing, pulling, reaching, carrying, or handling, and 4 5 mental functions such as the ability to understand, carry out, and remember simple instructions, 6 deal with changes in a routine work setting, use judgment, and respond appropriately to supervisors, 7 coworkers, and usual work situations. 20 C.F.R. § 404.1522, 416.922. 8 When reviewing an ALJ’s findings at step two the Court “must determine whether the ALJ 9 had substantial evidence to find that the medical evidence clearly established that [the claimant] 10 did not have a medically severe impairment or combination of impairments.” Webb, 433 F.3d at 11 687 (citing Yuckert v. Bowen, 841 F.2d 303, 306 (9th Cir. 1988) (“Despite the deference usually 12 13 accorded to the Secretary’s application of regulations, numerous appellate courts have imposed a 14 narrow construction upon the severity regulation applied here.”)). 15 Before proceeding to step four, the ALJ must first determine the claimant’s residual 16 functional capacity. Nowden v. Berryhill, No. EDCV 17-00584-JEM, 2018 WL 1155971, at *2 17 (C.D. Cal. Mar. 2, 2018). The RFC is “the most [one] can still do despite [his or her] limitations” 18 and represents an assessment “based on all the relevant evidence.” 20 C.F.R. §§ 404.1545(a)(1), 19 416.945(a)(1). 20 21 A determination of residual functional capacity is not a medical opinion, but a legal decision 22 that is expressly reserved for the Commissioner. See 20 C.F.R. §§ 404.1527(d)(2) (RFC is not a 23 medical opinion), 404.1546(c) (identifying the ALJ as responsible for determining RFC). “[I]t is 24 the responsibility of the ALJ, not the claimant’s physician, to determine residual functional 25 capacity.” Vertigan v. Halter, 260 F.3d 1044, 1049 (9th Cir. 2001). 26 “In determining a claimant’s RFC, an ALJ must consider all relevant evidence in the record 27 28 . . .” Robbins, 466 F.3d at 883. See also 20 C.F.R. § 404.1545(a)(3). “The ALJ can meet this burden by setting out a detailed and thorough summary of the facts and conflicting evidence, stating 2 his interpretation thereof, and making findings.” Magallanes v. Bowen, 881 F.2d 747, 751 (9th Cir. 3 1989) (quoting Cotton v. Bowen, 799 F.2d 1403, 1408 (9th Cir. 1986)). The RFC need not mirror 4 5 a particular opinion; it is an assessment formulated by the ALJ based on all relevant evidence. See 6 20 C.F.R. §§ 404.1545(a)(3). 7 In evaluating opinion evidence the ALJ considers the factors of supportability, consistency, 8 treatment relationship, specialization, and other factors. 20 C.F.R. § 404.1520c(c). Supportability 9 and consistency are the two most important factors and the ALJ must articulate how they are 10 considered. Id. 11 A claimant’s statements of pain or other symptoms are not conclusive evidence of a physical 12 13 or mental impairment or disability. 42 U.S.C. § 423(d)(5)(A); Soc. Sec. Rul. 16-3p. An ALJ 14 performs a two-step analysis to determine whether a claimant’s testimony regarding subjective pain 15 or symptoms is credible. See Garrison v. Colvin, 759 F.3d 995, 1014 (9th Cir. 2014); Smolen, 80 16 F.3d at 1281; S.S.R 16-3p at 3. First, the claimant must produce objective medical evidence of an 17 impairment that could reasonably be expected to produce some degree of the symptom or pain 18 alleged. Garrison, 759 F.3d at 1014; Smolen, 80 F.3d at 1281–82. If the claimant satisfies the first 19 step and there is no evidence of malingering, the ALJ must “evaluate the intensity and persistence 20 21 of [the claimant’s] symptoms to determine the extent to which the symptoms limit an individual’s 22 ability to perform work-related activities.” S.S.R. 16-3p at 2. An ALJ’s evaluation of a claimant’s 23 testimony must be supported by specific, clear and convincing reasons. Burrell v. Colvin, 775 F.3d 24 1133, 1136 (9th Cir. 2014); see also S.S.R. 16-3p at *10. 25 B. Analysis 26 The March 8, 2022 scheduling order requires, among other things, a short and separate 27 28 statement of Plaintiff’s legal claims, arguments separately addressing each claim, and legal and factual citations in support. Doc. 15 at 2. Because Plaintiff did not provide these, the Court will 2 address the Plaintiff’s brief piece by piece. 3 At pages 1 through 3 of the 6-page brief, Plaintiff recited the procedurally history without 4 5 analysis or argumentation. In the section labelled “Medical Evidence” Plaintiff stipulates “that the 6 ALJ fairly and accurately summarized the medical and non-medical evidence of record, except as 7 specifically stated in the Issues and Contentions.” Br. at 3, Doc. 16. There is no corresponding 8 section labelled “Issues and Contentions.” 9 There is however a section labeled “Disputed Issues” on page 3 which reads as follows: 10 In this case, Ms. Hanson is a 20 year old who weighs 450 pounds with right knee 11 dislocations as well as with a history of mental trauma and depression from verbal abuse from her stepfather who suddenly died. Physically she suffers from fatigue 12 and sometimes uses a cane for ambulation as well as a knee brace. She also 13 attempted suicide in May 2019. Despite a consultative examiner at 2F finding a full array of residual functional capacity, it is clear that this 450 pound individual has 14 some limitations. 15 Id. 16 This paragraph is not a statement of disputed issues because none of the assertions in this 17 paragraph are disputed. The strongest assertion in this paragraph is that Plaintiff does have some 18 limitations despite the consultative examiner’s opinion that she had a full array of residual 19 functional capacity. However the consultative examiner did not opine that Plaintiff had a full array 20 21 of residual functional capacity and, even if she had so opined, the ALJ did not adopt the consultative 22 examiner’s opinion. The consultative examiner opined that was restricted to medium exertional 23 work (50 pounds occasionally and 25 frequently) with postural limitations. AR 386. The ALJ 24 formulated an RFC even more restrictive than that. In short, all agree that Plaintiff has some 25 limitations. The question here is what limitations she has and, more specifically, did the ALJ 26 adequately account for those limitations in the RFC. Halfway through the motion for summary 27 28 judgment, Plaintiff’s thoughts on the issue have yet to be stated. Moving on to page 4 of the 6 page brief, Plaintiff quotes the ALJ’s RFC and then states, 2 “Yet it is unclear however upon which medical provider such a residual capacity is based.” Id. at 3 4. Contrary to Plaintiff’s suggestion, a determination of residual functional capacity is not a 4 5 medical opinion and need not mirror any medical opinion, rather it is a legal decision reserved for 6 the Commissioner. See 20 C.F.R. §§ 404.1527(d)(2); See 20 C.F.R. §§ 404.1545(a)(3). 7 Moreover, there is no basis here to suggest that the ALJ constructed the RFC based on her 8 own lay-person interpretation of the medical evidence in contravention of the medical opinions. 9 The consultative examiner Dr. Siekerkotte opined that Plaintiff could perform a slightly reduced 10 range of medium work (AR 385–86). Similarly, the non-examining physician, Dr. Khong, opined 11 that Plaintiff could perform a slightly reduced range of medium exertional work. AR 69-72. 12 13 Finally, the non-examining physician who reviewed Plaintiff’s file at the reconsideration level (Dr. 14 Spoor) opined that Plaintiff could perform light exertional work with postural restrictions and no 15 more than 3 hours of standing and walk. The ALJ adopted that RFC in essentially every respect 16 save for 3 hours of standing and walking. AR 89-90. In sum, the RFC was supported in every 17 respect by 2 out of 3 opinions, and largely supported by the third opinion save for the distinction 18 between 3 and 4 hours of standing and walking. 19 The ensuing 2 pages of Plaintiff’s brief contain block quotations of applicable law with no 20 21 analytical component. Finally, at page 6 of the brief, Plaintiff provides a short analysis which is 22 quoted in full here: 23 In this case, at p. 11 the ALJ notes that the consultative examiner (2F) reporting of almost a full range of work was less persuasive due to the obvious 24 limitations from claimant’s obesity. State Agency physician Dr. Khong (1A) finding 25 that claimant could perform a full range of medium work was less persuasive because it in essence followed the consultative examiner. And the State Agency 26 physician Dr. Spoor limiting claimant to light work, but with standing to no more than 3 hours was also found not persuasive because of claimant’s testimony that she 27 tried to find work as a fast food worker for 4 hours per day (see p. 12). There is no 28 medical evidence that supports this ALJ finding on functional capacity. The ALJ did include additional limitation of standing/walking up to 4 hours in an 8 hour day. Yet this is inconsistent with her testimony (AR p. 41-43) where 2 she states that she has trouble walking and standing, can walk about one block and uses a cane one to two times per week. She further describes spending much of her 3 time lying down to take the pressure of her 450 pounds off of her knee and back, and to recapture her breathing. The knee also dislocates and she wears a brace to 4 keep the knee in place (AR p. 48). Further she cannot crouch as this does dislocate 5 the knee (AR p. 47). Lastly, the lying down half to three quarters of the day and migraines, and her fear of leaving her home that she testified to would limit her 6 ability to be on task enough to maintain employment. An ALJ may consider daily activities that “may be inconsistent with the 7 presence of a condition which would preclude all work activity.” Curry v. Sullivan (1990) 928 F. 2d 1127, 1130. However, in this case claimant did not testify of an 8 ability to stand 4 hours per day and no records support this exact restriction. In fact 9 the medical opinion of Dr. Spoor provides only a 3 hour limitation. If the Court would have followed Dr. Spoor’s opinion of three hours of standing/walking, the 10 vocational expert found this residual capacity to be too restrictive for light work and sedentary restrictions should be considered along with the other limitations (AR p. 11 59). 12 Initially, Plaintiff disputes the ALJ’s rejection of Dr. Spoor’s opinion that Plaintiff was 13 limited to 3 hours of standing and walking. If the RFC assessment conflicts with an opinion from 14 a medical source, the ALJ must explain why the opinion was not adopted. SSR 96-8p. Further, 15 “[a]n ALJ may reject the opinion of nonexamining physicians so long as the ALJ references specific 16 17 evidence in the medical record’ that supports doing so”) (internal citation omitted). Burkett v. Saul, 18 806 Fed. Appx. 509, 511 (9th Cir. Mar. 6, 2020). 19 Here, the ALJ offered the following pertinent discussion: 20 As for Dr. Spoor’s assessment limiting standing/walking to 3 hours, the record does 21 not support this limitation. Notably, the record does not contain any imaging after the April 2019 right knee x-ray, which noted only mild medial compartment joint 22 space narrowing, but no acute abnormality, mass, or erosive changes (2F/7). Additionally, the record routinely reported physical examination findings within 23 normal limits (1F/4-5, 17, 24; 8F/47, 92, 304). Furthermore, when the claimant was looking for work in fast food, she was looking for 4 hours shifts because she felt she 24 could stand for about 4 hours (1F/22). Likewise, at the hearing, the claimant testified 25 she could stand for about 30 minutes at a time (hearing testimony), which is equivalent to 4 hours in an 8-hour workday. While these are purely subjective 26 statements from the claimant, they still suggest an ability to stand and walk of more than 3 hours. Overall, the limited physical evidence would easily support that the 27 claimant could perform all the exertional requirements of light work. However, out 28 of an abundance of caution, the undersigned finds it prudent to restrict the claimant to standing and walking no more than 4 hours in an 8-hour workday. The record does not reflect any objective findings to support further reductions. Apart from this 2 change, the undersigned finds Dr. Spoor’s assessment persuasive. 3 Thus, the ALJ specifically underscored the lone time in which she departed from Dr. 4 Spoor’s opinion, namely the restriction to 3 hours of standing and walking (as compared to the RFC 5 which specified 4 hours of standing and walking). The ALJ rejected the 3 hour restriction in light 6 of the most recent knee x-ray showing only mild abnormalities, as well as physical examinations 7 within normal limits. Plaintiff did not acknowledge or dispute this portion of the discussion. A 8 9 review of the cited exhibits confirms the ALJ did not unreas onably characterize those exams as 10 within normal limits, at least in respect which would be relevant to standing and walking capacities. 11 At a February 6, 2019 visit, although the primary diagnosis was gender dysphoria, the 12 review of systems (musculoskeletal) was negative for joint pain and myalgia and her gait was 13 normal. Ex. 1F/4-5, AR 259–60. At a visit on October 26, 2018, review of musculoskeletal system 14 was also negative for joint pain and myalgia and normal gate was noted. Ex 1F at 17 (AR 271). 15 The same findings were noted on October 1, 2018. AR 279.3 16 17 The ALJ also cited a psychiatric progress note dated October 1, 2018 which states, “she is 18 looking for jobs in fast food and states she can only work about a 4 hour shift due to not being able 19 to stand for long periods of time.” Ex. 1F/22 (AR 277). Although this was only one isolated 20 statement, it is uniquely relevant to the issue at bar, namely whether Plaintiff could stand for 3 21 hours (as opined by Dr. Spoor), or for 4 hours (as the ALJ found). 22 In Plaintiff’s second argumentative paragraph, she underscores her testimony that she can 23 24 25 3 The unstated assumption here is that the physician or nurse actually performed a comprehensive review of systems and physical examination, including musculoskeletal. But this seems unlikely. These were not orthopedic 26 consultations or primary care visits. These were follow up visits for gender dysphoria with an endocrinologist, Dr. Ronakkumar Dwarkadas Patel, to discuss treatment options such as hormonal therapy. This might explain why a 27 review of systems (musculoskeletal) was listed as negative for joint pain and myalgia as musculoskeletal complaints were likely not a topic central to the nature of the visit. Nevertheless, Plaintiff did not identify this issue, and the 28 ALJ’s reasoning for rejecting the 3-hour standing and walking limitation was sufficient overall for the reasons discussed in more detail below. walk no further than 1 block without resting, spends most of the day lying down due to back and 2 knee pain, requires a knee brace due to knee dislocation, cannot crouch due to knee dislocation, 3 suffers migraines, and fears leaving the home. Br. at 6. She contends the RFC is inconsistent with 4 5 these limitations. 6 Here, the ALJ acknowledged each piece of testimony Plaintiff underscores, and the ALJ 7 also identified specific reasons for rejecting that testimony. The ALJ simply did so at step two in 8 finding the impairments non-severe. With respect to migraines, the ALJ noted they were well 9 controlled by propranolol. AR 18 (citing Ex. 1F/4, 16, 36). The cited records mostly support the 10 proposition for which the ALJ cited them as follows: Exhibit 1F/4 is a progress note dated February 11 6, 2019 which notes under clinical summary: “migraine controlled Propranolol.” AR 259; Exhibit 12 13 1F/16 is a progress note dated October 26, 2018 which notes “migraine history since childhood. 14 take(s) Tylenol and propranolol. reports that her migraine well controlled current meds.” AR 271; 15 Exhibit 1F/36 is a psychiatric progress note dated August 11, 2018, which simply lists her migraine 16 medications but doesn’t comment on how well her migraines are controlled. AR 291. Thus the 17 record sufficiently supports that Plaintiff’s migraines were well controlled by medication and not a 18 severe impairment warranting any work restrictions. Plaintiff offers no reason to believe otherwise. 19 With respect to her knee pain, dislocation, brace use, cane use, and associated alleged 20 21 limitations on standing, walking, and crouching, the ALJ made several pertinent findings. First, 22 the ALJ noted only mild knee abnormalities on knee x-ray. AR 18 (citing Ex. 2F/7). The x-ray 23 results note no acute fracture or dislocation; mild medical compartment joint space narrowing; no 24 soft tissue swelling, effusion, or other abnormality. AR 388. The ALJ acknowledged that Plaintiff 25 reported pain and dislocation to her providers on at least one occasion, but noted the absence of any 26 records noting dislocation or any objective corroboration for her alleged need for a brace or cane. 27 28 The ALJ also noted that cane use was absent from Plaintiff’s function report and from a third party report submitted by her mother. AR 18 (citing Ex. 3E, 4E, and 13E; AR 186–93, 194–205, and 2 239–40). 3 As to Plaintiff’s knee functioning more generally, the ALJ cited physical examination 4 5 findings from January 30, 2020 which reflected no leg swelling, redness, or pain upon 6 musculoskeletal examination. AR 19 (citing Ex, 8F/304, AR 781). The ALJ also cited the 7 consultative examination at which Plaintiff was able to walk, stand on toes, heels, and on one leg 8 alone, as well as squat (2F/3). AR 384–85. The consultative examiner did, however, note patella 9 motion tenderness and that Plaintiff walks on the outside of her right foot, findings the ALJ did not 10 appear to acknowledge. Id. 11 With respect to Plaintiff’s back pain, the ALJ again cited the consultative examination at 12 13 which Plaintiff had tenderness to palpation across her low back, but otherwise had normal range of 14 motion, strength, reflexes and sensation. Id. The ALJ further noted the absence of any imaging of 15 Plaintiff’s back and no other basis upon which to find an “organic” back condition as the cause of 16 Plaintiff’s alleged back pain. Id. Indeed, there appears to be no such evidence in the record, nor 17 does Plaintiff identify any. 18 On balance, the ALJ reached a reasonable conclusion based on the limited records available 19 concerning Plaintiff’s knee pain and back pain. The record reflected mild abnormalities on knee 20 21 x-ray, no imaging of her back, and essentially no abnormalities by way of physical examination 22 other than tenderness in her back, tenderness in her patella, and the fact that she walks on the outside 23 of her right foot. Although the ALJ found no severe knee or back impairment, the ALJ did include 24 restrictions at the RFC stage in consideration of Plaintiff’s obesity which might be expected to 25 cause knee and back symptoms. Accordingly, the ALJ limited Plaintiff to 4 hours of standing and 26 walking with occasional postural activities. This finding was supported by the cited medical 27 28 records, the opinions of 1 out of 2 non-examining physicians, and the opinion of the consultative examiner. 2 As to Plaintiff’s alleged fear of leaving the house, the ALJ noted there was no evidence 3 she’d ever been diagnosed with agoraphobia. Further, the ALJ found that allegation inconsistent 4 5 with evidence that she was filling out job applications for fast food jobs, attending an “options 6 class” related to bariatric surgery (1F/39), and using a gym membership/personal trainer to try to 7 lose weight (hearing testimony). However, attending one class to explore bariatric surgery options 8 is not inconsistent with the notion that she fears leaving the home. The same can be said of the 9 non-specific reference to “using a gym/personal trainer” with no details as to when or where these 10 personal training sessions took place, with what frequency, or for what duration. Nevertheless, the 11 lack of evidence of an agoraphobia diagnosis, and the several instances in the record reflecting 12 13 Plaintiff was looking for work ((1F/22; 1F/13; 2F/2; 7F/3; AR 277, 268, 283, 473) undermine her 14 allegation that fear of leaving the home is an impediment to her ability to work. 15 Plaintiff’s third and final argumentative paragraph repeats the contention that Dr. Spoor’s 16 3 hour standing/walking limitation should have been adopted in lieu of the ALJ’s 4 hour restriction 17 because “no records support this exact restriction” (namely the ALJ’s 4 hour standing/walking 18 restriction). The argument appears to be predicated on the same misunderstanding discussed above, 19 namely that the RFC must mirror an opinion. The fact that the ALJ’s RFC was more restrictive 20 21 than 2 of the medical opinions does not mean the RFC was unsupported by those opinions. The 22 opinions of Drs. Khong (non-examining) and Siekerkotte (consultative examiner) do support the 23 restriction that Plaintiff is limited to 4 hours of standing and walking. 24 Moreover, Plaintiff’s contention that the ALJ arbitrarily chose 4 hours of standing/walking 25 is not well taken. As the ALJ emphasized, Plaintiff came up with that 4-hour estimate herself at a 26 psychiatric appointment which notes as follows: “she is looking for jobs in fast food and states she 27 28 can only work about a 4 hour shift due to not being able to stand for long periods of time.” Ex. 1F/22 (AR 277). In sum, Plaintiff identifies no error in the ALJ’s analysis. 2 VI. Order 3 For the reasons stated above, the Court finds that substantial evidence and applicable law 4 5 support the ALJ’s conclusion that Plaintiff was not disabled. Accordingly, Plaintiff’s appeal from 6 the administrative decision of the Commissioner of Social Security is denied. The Clerk of Court 7 is directed to enter judgment in favor of Defendant Kilolo Kijakazi, acting Commissioner of Social 8 Security, and against Plaintiff Martin Justin (Amy) Hanson. 9 10 IT IS SO ORDERED. 11 12 Dated: January 7, 2023 /s/ Gary S. Austin UNITED STATES MAGISTRATE JUDGE 13 14 15 16 17 18 19 20 21 22 23 24 25 26 27 28