Tirajo Shimakonis v. Kilolo Kijakazi

NOT FOR PUBLICATION FILED
UNITED STATES COURT OF APPEALS JUN 14 2023
MOLLY C. DWYER, CLERK
U.S. COURT OF APPEALS
FOR THE NINTH CIRCUIT
TIRAJO J. SHIMAKONIS, No. 22-35443
Plaintiff-Appellant, D.C. No. 3:21-cv-05569-BAT
v.
MEMORANDUM*
KILOLO KIJAKAZI, Acting Commissioner
of Social Security,
Defendant-Appellee.
Appeal from the United States District Court
for the Western District of Washington
Brian Tsuchida, Magistrate Judge, Presiding
Submitted June 8, 2023**
Seattle, Washington
Before: HAWKINS, BEA, and BRESS, Circuit Judges.
Tirajo Shimakonis (“Shimakonis”) appeals the district court’s order affirming
the Commissioner of Social Security’s denial of her application for disability
*
This disposition is not appropriate for publication and is not precedent
except as provided by Ninth Circuit Rule 36-3.
**
The panel unanimously concludes this case is suitable for decision
without oral argument. See Fed. R. App. P. 34(a)(2).
insurance benefits. We review the Commissioner’s decision for substantial
evidence, Webb v. Barnhart, 433 F.3d 683, 686 (9th Cir. 2005), and we affirm.
I. Medical Opinion Evidence
A. Dr. Goldfine
Substantial evidence supports the ALJ’s decision to disregard a portion of Dr.
Goldfine’s opinion in which Goldfine concluded that Shimakonis was chronically
fatigued, lacked motivation, and had difficulty maintaining attention and
concentration, and that this would make it difficult reliably to sustain a normal work
routine. The ALJ concluded this opinion was inconsistent with Shimakonis’s “active
lifestyle, which has included caring for a young child which can be quite demanding
both physically and emotionally.”
A conflict between a doctor’s opinion and a claimant’s activity level
constitutes a valid basis for rejecting the opinion. Ford v. Saul, 950 F.3d 1141,
1154‒55 (9th Cir. 2020). This circuit has previously discounted “restrictions [that]
appear to be inconsistent with the level of activity that [a claimant] engage[s] in by
maintaining a household and raising two young children with no significant
assistance.” Rollins v. Massanari, 261 F.3d 853, 856 (9th Cir. 2001); see also Smartt
v. Kijakazi, 53 F.4th 489, 499‒500 (9th Cir. 2022) (finding claimant’s daily
activities—including caring for her daughter by bathing, feeding, and taking her to
school—“require many of the same capabilities . . . necessary for obtaining and
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maintaining employment”). Moreover, the ALJ mentioned childcare as one example
of Shimakonis’s active lifestyle; the previous several pages discuss and detail
numerous other examples of her daily activities, and this court must look for the full
explanation in “all the pages of the ALJ’s decision.” Kaufmann v. Kijakazi, 32 F.4th
843, 851 (9th Cir. 2022).
B. Ms. Huggins and Ms. Becerra
Substantial evidence also supports the ALJ’s treatment of the opinions of two
nurse practitioners regarding Shimakonis’s mental health and abilities. The ALJ
discounted these opinions for being inconsistent with one another, “which render the
opinions less persuasive,” and also for being inconsistent with information about
Shimakonis and her daily activities, which included social interactions with her
friend and boyfriend, and carrying out instructions/simple tasks when making
jewelry and quilts. Consistency is one of the two most important factors in assessing
medical opinions under the governing regulations, 20 C.F.R. § 416.920c(b)(2), and
the ALJ gave adequate reasons supported by evidence of inconsistencies between
the two opinions and between the opinions and other evidence in the record. See,
e.g., Ford, 950 F.3d at 1156; Woods v. Kijakazi, 32 F.4th 785, 792‒93 (9th Cir.
2022).
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C. Dr. Bendheim
Dr. Bendheim examined Shimakonis in October 2018 and opined she had no
impairment that would impose more than minimal limitations for twelve continuous
months. The ALJ disagreed, noting “the record does support a finding that she has
exertional and postural limitations,” but that the opinion supported the ultimate
conclusion that Shimakonis was not fully disabled.
It is not entirely clear why Shimakonis is objecting to the ALJ’s treatment of
this opinion, as the ALJ largely rejected the portions of Dr. Bendheim’s opinion that
were unfavorable to her. Nor has Shimakonis explained how the ALJ’s statement
that the opinion otherwise supports the ultimate conclusion of non-disability is
erroneous.1
II. Shimakonis and Her Father’s Lay Testimony
The ALJ did not fully credit Shimakonis’s testimony regarding the intensity,
persistence, and limiting effects of her symptoms for a variety of reasons that are
supported by substantial evidence, including: (1) daily activities that were
inconsistent with the severity of her allegations, see Smartt, 53 F.4th at 499‒500;
Molina v. Astrue, 674 F.3d 1104, 1113 (9th Cir. 2012); (2) situational stressors, such
as the death of her mother, a physical assault and a car accident, had created a
1
To the extent that Shimakonis relies on other medical records and treatment notes
to support her disability claim, this evidence does not show that the ALJ’s non-
disability finding was unsupported by substantial evidence.
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temporary worsening of mental health symptoms but were unlikely to persist over
time, see Tidwell v. Apfel, 161 F.3d 599, 602 (9th Cir. 1998); (3) both her physical
and mental health conditions had improved with treatment such as steroid injections,
diet, and behavioral therapy, see Wellington v. Berryhill, 878 F.3d 867, 876 (9th Cir.
2017); and (4) her reported severity of symptoms was inconsistent with medical
evidence, including mental health status examinations and diagnostic imaging that
showed “mild” degenerative changes or spinal abnormalities, see Smartt, 53 F.4th at
498‒99; Parra v. Astrue, 481 F.3d 742, 750 (9th Cir. 2007).2
These constitute “specific, clear, and convincing reasons supporting a finding
that [Shimakonis’s] limitations were not as severe as [s]he claimed.” Ahearn v. Saul,
988 F.3d 1111, 1117 (9th Cir. 2021). The ALJ also found Shimakonis’s father’s
written report “unpersuasive for the same reasons that the claimant’s own allegations
do not fully persuade,” and these are similarly valid reasons to reject lay witness
testimony. Valentine v. Comm’r Soc. Sec. Admin., 574 F.3d 685, 694 (9th Cir.
2009).
2
The ALJ also remarked on Shimakonis’s failure to follow treatment
recommendations such as taking medications as prescribed or continuing physical
therapy. However, Shimakonis did notify her physical therapist she needed to “hold
therapy” for childcare reasons, and the record reflects that she did have trouble
remembering to take her medications and was provided a home health aide for
support with medication. In any event, even disregarding this justification, the ALJ
offered other sufficient reasons for discounting her testimony, which were supported
by substantial evidence. See Ford, 950 F.3d at 1156 n.8.
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Having given sufficient explanations for discounting the medical opinions,
Shimakonis’s testimony, and her father’s written statement, the ALJ properly
determined Shimakonis’s residual functional capacity, and the questions posed to
the vocational expert contained all relevant limitations.
AFFIRMED.
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