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Christy v. Colvin

United States District Court, W.D. Washington, at Tacoma

November 6, 2014

ANGELA MARIE CHRISTY, Plaintiff,
v.
CAROLYN W. COLVIN, Acting Commissioner of the Social Security Administration, Defendant.

ORDER ON PLAINTIFF'S COMPLAINT

J. RICHARD CREATURA, Magistrate Judge.

This Court has jurisdiction pursuant to 28 U.S.C. § 636(c), Fed.R.Civ.P. 73 and Local Magistrate Judge Rule MJR 13 ( see also Notice of Initial Assignment to a U.S. Magistrate Judge and Consent Form, ECF No. 3; Consent to Proceed Before a United States Magistrate Judge, ECF No. 4). This matter has been fully briefed ( see ECF Nos. 12, 16, 17).

After considering and reviewing the record, the Court concludes that the ALJ provided clear and convincing reasons for failing to credit fully plaintiff's allegations and testimony, including her non-compliance with medical treatment, but her improvement when compliant; lack of motivation to work; and inconsistent statements. The ALJ also provided specific and legitimate rationale for his failure to credit fully all of the medical opinions, noting for example, that plaintiff's objective test results indicated that plaintiff was over-reporting unlikely symptoms, that one doctor strongly suspected malingering and another doctor opined that plaintiff's profile was "definitely exaggerated." Because the doctors relied on plaintiff's unreliable self-reporting when providing their opinions, the ALJ properly declined to credit fully all of their opinions.

Therefore, this matter is affirmed pursuant to sentence four of 42 U.S.C. § 405(g).

BACKGROUND

Plaintiff, ANGELA MARIE CHRISTY, was born in 1979 and was 28 years old on the alleged date of disability onset of January 1, 2008 ( see Tr. 123-25). However, because plaintiff has applied only for supplemental security income, which is not payable prior to the month following the month in which the application was filed and plaintiff filed her application on January 29, 2009, the ALJ's written decision includes findings and conclusions regarding plaintiff's condition since January 29, 2009, although the ALJ indicates that he considered the complete medical history ( see Tr. 623, 625).

Plaintiff left school after the 8th grade (Tr. 27). Plaintiff has worked as a dishwasher, as a hostess in a restaurant, as a customer service/video, and on an assembly line (Tr. 213-17). At her first administrative hearing in December, 2010, plaintiff could not remember the last time that she had held a job ( see Tr. 50).

According to the ALJ, at the time of latest hearing on December 6, 2013, plaintiff had at least the severe impairments of "degenerative joint disease in the knees; gastroesophageal reflux disease; diabetes; fibromyalgia; obesity; carpal tunnel syndrome; depression; bipolar disorder; panic disorder without agoraphobia; cognitive disorder; personality disorder; and drug abuse (20 CFR 416.920(c))" (Tr. 625).

At the time of the hearing, plaintiff was separated from her husband and living in an apartment with two of her minor children (Tr. 628).

PROCEDURAL HISTORY

Plaintiff provides the following procedural history:

Ms. Christy protectively filed an application for supplemental security income on January 29, 2009, wherein she alleged disability on January 1, 2008 (Tr. 123-125). Her applications were denied at the initial determination and reconsideration stages (Tr. 84-87, 91-93). Ms. Christy thereafter filed a Request for Hearing (Tr. 94-96). A hearing was held before an administrative law judge on December 17, 2010 in Portland, Oregon (Tr. 46-64). The ALJ issued a decision on December 29, 2010, denying plaintiff's claim (Tr. 14-37). Plaintiff appealed the decision to the Appeals Council on February 23, 2011, and an Order denying review of the decision of the ALJ was issued on January 19, 2012 (Tr. 1-9).
Ms. Christy filed an action in the United States District Court for the Western District of Washington on March 21, 2012 (Tr. 760-762). On December 4, 2012, an Order was issued by United States Magistrate Judge J. Richard Creatura, remanding the case to the Commissioner, pursuant to sentence four of 42 U.S.C. § 405(g) (Tr. 704-727). The Appeals Council issued a further Order dated May 24, 2013, vacating the hearing decision dated December 29, 2010 and remanding the case back to the ALJ (Tr. 728-731).
A hearing was held on December 6, 2013 before an ALJ (Tr. 672-703). The ALJ issued a decision on January 6, 2014, denying plaintiff's claim (Tr. 620-649). Following this decision, plaintiff did not file written exceptions with the Appeals Council, and the Appeals Council did not assume jurisdiction. Ms. Christy thereafter made timely appeal to the instant court seeking review of the denial of benefits.

( See Plaintiff's Opening Brief, ECF No. 12, pp. 1-2).

Plaintiff raises the following issues: (1) Whether or not the ALJ properly evaluated the medical issues; and (2) Did the ALJ provide clear and convincing reasons to discredit plaintiff's testimony ( see Defendant's Brief, ECF No. 16, p. 2).

STANDARD OF REVIEW

Pursuant to 42 U.S.C. § 405(g), this Court may set aside the Commissioner's denial of social security benefits if the ALJ's findings are based on legal error or not supported by substantial evidence in the record as a whole. Bayliss v. Barnhart, 427 F.3d 1211, 1214 n.1 (9th Cir. 2005) ( citing Tidwell v. Apfel, 161 F.3d 599, 601 (9th Cir. 1999)).

DISCUSSION

(1) Whether or not the ALJ properly evaluated the medical issues.

Plaintiff contends that the ALJ failed to evaluate appropriately multiple medical opinions. Defendant contends that the ALJ provided specific and legitimate rationale for failing to credit the opinions, and also provided a sufficiently detailed and thorough discussion of the evidence in the record.

When an opinion from an examining or treating doctor is contradicted by other medical opinions, the treating or examining doctor's opinion can be rejected "for specific and legitimate reasons that are supported by substantial evidence in the record." Lester v. Chater, 81 F.3d 821, 830-31 (9th Cir. 1996) ( citing Andrews v. Shalala, 53 F.3d 1035, 1043 (9th Cir. 1995); Murray v. Heckler, 722 F.2d 499, 502 (9th Cir. 1983)). The ALJ can accomplish this by "setting out a detailed and thorough summary of the facts and conflicting clinical evidence, stating his interpretation thereof, and making findings." Reddick v. Chater, 157 F.3d 715, 725 (9th Cir. 1998) ( citing Magallanes v. Bowen, 881 F.2d 747, 751 (9th Cir. 1989)).

A. Dr. Wendy Biss, Ph.D., examining doctor

Dr. Biss examined plaintiff in May 2008 ( see Tr. 324-33). Dr. Biss noted plaintiff's report of recurring feelings of depression on most days, as well as returning anxiety when outside her home and recurring feelings of hopelessness ( see Tr. 327). Dr. Biss noted plaintiff's report that she was having difficulty leaving the home and being around people ( see Tr. 328). Regarding plaintiff's mini mental status examination, Dr. Biss noted that plaintiff "consecutively completed forward digit span up to six digits" ( see id. ). Although Dr. Biss noted that plaintiff appeared to have more difficulty with tasks related to abstract reasoning, Dr. Biss opined that this result "may have reflected her minimal effort on these tasks" ( see id. ). Although plaintiff "did not attempt abstract reasoning related to proverbs, [plaintiff] was able to provide correct answers to all similarities" ( see id. ). Dr. Biss noted that when plaintiff was asked questions related to comprehension and ways to manage basic safety behaviors, plaintiff "also appeared to give limited effort and appeared somewhat uncooperative" ( see id. ). Dr. Biss noted that plaintiff's "answers were often quick and brief, with limited effort or thought" ( see id. ). Dr. Biss provided an example: when plaintiff was answering the question regarding why individuals are expected to pay taxes, "she reported, never had to pay taxes, so it doesn't catch up to you later'" ( see id. ).

Plaintiff reported that she consumed alcohol infrequently at social events ( see id. ). Dr. Biss also noted plaintiff's report that "her Valium doesn't help and she often over uses the medication" ( see id. ). Dr. Biss noted that plaintiff "reported that she left school in eighth grade due to behavioral difficulties" ( see Tr. 329). Dr. Biss noted that plaintiff "reported that when she placed effort into her behaviors she was capable of receiving A's" ( see id. ). Dr. Biss noted plaintiff's report of very few jobs since her teenage years ( see id. ).

Dr. Biss noted that plaintiff reported that she had driven herself to the interview, but also reported that her driver's license was invalid, but that she continues to drive anyway ( see Tr. 329-30). Dr. Biss also noted that plaintiff did not show up for her previously scheduled appointment "and could not provide an explanation of what precipitated her absence from the first scheduled appointment" ( see Tr. 330).

Dr. Biss opined that plaintiff's mood throughout the interview and testing "was somewhat incongruent to her reported affect of anxious and depressed" ( see id. ). Dr. Biss noted that plaintiff appeared lethargic, detached, bored, and disinterested, but that her reported "anxiety was not visibly noticeable" ( see id. ). Dr. Biss observed that plaintiff's speech often was "overly vague and contradictory" and that plaintiff appeared somewhat uncooperative ( see id. ). Dr. Biss opined that although plaintiff's speech was slow, it was logical ( see id. ).

Regarding plaintiff's mini-mental status exam (MMSE) results, Dr. Biss noted that plaintiff fell within the normal range for her performance ( see id. ). Dr. Biss also noted that plaintiff did not appear to have any deficits in her remote or recent memory, although she appeared to have the most difficulty with delayed recall ( see id. ). Dr. Biss opined that based on plaintiff's presentation during testing, plaintiff "appeared able to: easily read and write small sentences, perform immediate recall, name common objects, perform basic attention tasks, such as spelling backwards, perform basic repetition, perform tasks of visual motor integration, and follow three-step commands" ( see id. ).

Dr. Biss also conducted objective testing regarding the validity of plaintiff's self reports. As noted in the 2008 opinion by Dr. Biss, the "Structured Inventory of Malingered Symptomatology (SIMS) is a 75 - item self-report measure that is used to detect malingering across a wide variety of clinical and forensic settings, [and a] SIMS Total Score of 14 or greater is used to detect malingered responding and provides a high level of sensitivity and specificity [while] a cutoff score of 16 is often used to enhance diagnostic accuracy and correctly identify 90% of malingerers and 98% of honest responders" (Tr. 330). As noted by Dr. Biss, plaintiff's "Total Score for the SIMS was a 38, therefore far outweighing the conservative cutoff score of 16" ( see id. ). Dr. Biss noted that plaintiff "over reported symptoms in every category except psychosis" ( see id. ).

Dr. Biss opined that plaintiff's "performance on the SIMS along with her erratic and apathetic performance throughout testing indicate that she likely overreported her level of distress and level of cognitive impairment" ( see Tr. 331). Dr. Biss opined that it was "very likely that her scores on the MMSE and measures of ADL's may not be wholly accurate depictions of her current functioning" ( see id. ). Dr. Biss also indicated her opinion as follows: "[Plaintiff's] scores on the SIMS indicate a very high likelihood that she overreported symptoms of impairment and failed to perform a full effort on all measures. Due [to] the potential for monetary gain and her reported inability to sustain full - time employment in the past malingering is strongly suspected" ( see id. ). For one of her recommendations, Dr. Biss indicated that "[when] interpreting the results be cautious as it is very likely [plaintiff] overreported her level of dysfunction and did not perform fully on all tasks" ( see id. ).

Among her major findings, Dr. Biss indicated that plaintiff's "overreporting of symptoms, use of lying for personal gain, likelihood of malingering, consistent irresponsibility, and lack of remorse appear consistent with Antisocial traits" ( see Tr. 332). Dr. Biss noted plaintiff's report that plaintiff indicated she was capable of receiving A's in school when she placed effort into her behaviors, and noted that during the interview, plaintiff "spoke in a very self pitying and contradictory manner" ( see id. ). Dr. Biss indicated that it "was very difficult to ascertain the accuracy of her reporting due to her inconsistency" ( see id. ).

Dr. Biss indicated that plaintiff likely would have difficulty accepting instruction from others because of plaintiff's apathy, disinterest, and difficulties with authority ( see Tr. 333). She indicated that plaintiff's difficulty in this area was moderate ( see Tr. 325). Dr. Biss also opined that based on plaintiff's MMSE performance, "and her answers to questions throughout the diagnostic interview she appears to [be] able to support herself based on her cognitive abilities" ( see Tr. 333). Dr. Biss opined that plaintiff's lack of full completion of her household chores "appears largely related to her apathy, lack of motivation, and anhedonia" ( see id. ).

The ALJ discussed the 2008 opinion of Dr. Biss ( see Tr. 637). The ALJ included the following discussion in his written decision:

Wendy Biss, Ph.D., completed a medical source statement of ability to do work-related mental activities in May 2008. She also provided an adult diagnostic assessment (internal citation to Ex. 11F). Dr. Biss opined the claimant's ability to understand, remember and carry out instructions is not affected by her impairments. She has no limitation in her ability to respond appropriately to usual work situations and to changes in a routine work setting. She has moderate limitation in the ability to interact appropriately with the public, supervisors, and co- workers because of antisocial/borderline personality traits (internal citation to Ex. 11F/2). This opinion is given little weight because of the claimant's lack of credibility and because of Dr. Biss' findings regarding potential malingering. Objective testing in the form of the structured inventory of malingered symptomatology (SIMS) reflected over reporting of unlikely symptoms in every category except psychosis (internal citation to Ex. 11F/7). The claimant's performance on the Minnesota Multiphasic Personality Inventory (MMPI-2) administered by another examiner also revealed that the claimant was endorsing infrequent, unlikely and unrealistic psychiatric symptoms (internal citation to Ex. 19F/5). Dr. Biss concluded that based on the claimant's erratic and apathetic performance throughout testing, malingering was strongly suspected (internal citation to Ex. 11F/8). Such evidence of lack of effort mirrors problems with the claimant's performance noted by the consultative examiner who evaluated the claimant's physical impairments (internal citation to Ex. 23F/6-7). Giving the claimant's complaints of social anxiety (internal citation to Ex. 19F/2) and alleged difficulties with concentration (internal citation to Ex. 19F/3) a modicum of weight against the backdrop of her estimated average IQ (internal citation to Ex. 19F/4), the undersigned added limitations restricting the claimant to unskilled work with limited public interactivity.

(Tr. 637-38).

Based on a review of the record, the Court concludes that the ALJ's characterizations and findings are based on substantial evidence in the record as a whole. As noted by the ALJ, in addition to the SIMS, another objective psychological test, which was conducted by Dr. Robert E. Schneider, Ph.D., in October, 2008, the MMPI-2 (Minnesota Multiphasic Personality Inventory), also "indicates over-reporting of symptoms" ( see Tr. 375). As noted by Dr. Schneider, plaintiff "was endorsing infrequent, unlikely and unrealistic psychiatric symptoms" ( see id. ). The Court also notes that Dr. Biss included in her opinion the recommendation that one "be cautious" when interpreting the results indicated in the opinion because "it is very likely [plaintiff] over reported her level of dysfunction and did not perform fully on all tasks" (Tr. 331).

For the reasons stated and based on a review of the record as a whole, including the ALJ's thorough discussion "of the facts and conflicting clinical evidence, stating his interpretation thereof, and making findings, " the Court concludes that the ALJ provided specific and legitimate rationale for failing to credit fully all the opinions included in Dr. Biss' report. See Reddick v. Chater, 157 F.3d 715, 725 (9th Cir. 1998) ( citing Magallanes v. Bowen, 881 F.2d 747, 751 (9th Cir. 1989)); see also Lester v. Chater, 81 F.3d 821, 830-31 (9th Cir. 1996) ( citing Andrews v. Shalala, 53 F.3d 1035, 1043 (9th Cir. 1995); Murray v. Heckler, 722 F.2d 499, 502 (9th Cir. 1983)).

B. Dr. Robert Schneider, Ph.D., examining doctor

Dr. Schneider examined plaintiff on two occasions, most relevantly, in October 2008, after plaintiff's head injury ( see Tr. 371-76). Dr. Schneider noted plaintiff's report that her "thinking has been confused since the accident" ( see Tr. 372). He noted her report that she felt as if her biggest problem was her memory ( see id. ). He noted her report that when she watches television she cannot remember what she was watching after commercial breaks ( see id. ). He also noted that she reported being anxious and attempted to avoid being with more than one person ( see id. ). Dr. Schneider noted plaintiff's report of depression and high anxiety, along with frequent panic attacks and social anxiety ( see id. ).

Dr. Schneider also indicated plaintiff's report that a doctor at Family Health Center diagnosed her with attention deficit disorder ( see Tr. 373). Dr. Schneider noted that plaintiff ranked her depression "as 10 out of 10, with 10 being the worst depression she could imagine and anxiety is 10 out of 10" ( see id. ). He noted plaintiff's report that there was nothing enjoyable in her life anymore ( see id. ). Dr. Schneider also noted plaintiff's report that plaintiff "was able to work until she suffered her head injury" ( see id. ). He also noted her opinion that she "would have to work alone because she has difficulty being around others" ( see Tr. 374). Regarding her vocational interests, Dr. Schneider noted plaintiff's report that "there is nothing that she can think of that she is able to do" ( see id. ).

Dr. Schneider also conducted a mental status evaluation and noted plaintiff's extremely flat affect and that she was very slow to respond, demonstrating extremely low energy ( see id. ). He indicated that plaintiff barely had sufficient energy to perform the tests and noted various tests that she was not able to perform, such as her struggle to conduct serial three subtractions and serial seven additions ( see id. ). However, he noted that she responded appropriately to a question testing her judgment, was able to interpret proverbs accurately and was able to identify similarities between objects ( see id. ).

Dr. Schneider administered a number of tasks, such as the Weschler Adult Intelligence Scales test, which indicated that plaintiff's IQ was equivalent to 97, which placed her precisely at the average level ( see id. ). He also administered Trails A and B, in which plaintiff was asked to connect sequentially various numbered dots, and opined that her score on Trails B was impaired relative to her intelligence ( see id. ). Dr. Schneider administered the Verbal Memory Subtest, in which plaintiff scored at the lower end of the low average range, which was below expected level but did not indicate severe impairment ( see Tr. 375). Dr. Schneider administered the Fluency Subtests from the Woodcock Johnson-III and noted that she "scored at the 11th grade level on the Reading Fluency Test and the 7.1 grade level on the math fluency" ( see id. ).

The Court noted previously the MMPI-2 test administered by Dr. Schneider, see supra, section 1.A ( see id. ). He noted that her "F - K index was 17, which invalidates the profile and indicates over reporting of symptoms" ( see id. ). Dr. Schneider noted that similarly, plaintiff generated a "T - score of 92 on the exaggeration of impairment scale" and that plaintiff also "generated an extremely high score on the scale that indicates she was endorsing infrequent, unlikely and unrealistic psychiatric symptoms" ( see id. ). Dr. Schneider noted that plaintiff's profile was "definitely exaggerated, " but Dr. Schneider opined that plaintiff was "an individual who views herself as the sum of her symptoms and, in fact, one of the characteristics of post concussive syndrome is a wide range of unexplainable symptoms and physical difficulties" ( see id. ). The Court notes that, as argued by defendant, this aspect of Dr. Schneiders' opinion suggests that he found plaintiff's exaggeration to demonstrate only a symptom of plaintiff's brain injury, as opposed to reflecting any attempt on the part of plaintiff to exaggerate her symptoms or to present herself as more disabled than she actually was ( see ECF No. 16, p. 8). Subsequently, Dr. Schneider indicated his opinion that plaintiff described "residual symptomatology that is very consistent with the head injury" ( see Tr. 376).

As noted by the ALJ, Dr. Schneider indicated that with the number of cognitive and physical problems with which plaintiff presented, Dr. Schneider opined that it was very unlikely that plaintiff could sustain the typical demands of gainful employment ( see Tr. 375). He opined that it was unlikely that plaintiff could tolerate the typical stresses, demands or expectations of competitive employment at that time ( see Tr. 376). Dr. Schneider opined that there was a lack of evidence demonstrating ADHD, and that the "PTSD like symptoms are more of a concern than actual PTSD symptoms, " opining that "this does not fit the criteria for traumatic events" ( see id. ). Dr. Schneider indicated that he did not have "sufficient time to develop a clear chronology of the development of all these symptoms, many of which may be related to the head injury" ( see id. ). He also found that her social anxiety required further exploration and also probably was related to the head injury.

The ALJ gave "little weight" to Dr. Schneider's opinion ( see Tr. 638). The ALJ reasoned as follows:

It is inconsistent with the objective testing (SIMS and MMPI - 2) showing that the claimant exaggerated her symptoms and was likely malingering as well as with evidence of inconsistent statements about the claimant's abilities. It also does not square with recent evidence showing improved function with medication when taken as prescribed. It is also inconsistent with the claimant['s] marginal work history even prior to her experiencing her head injury, as already explained.

(Tr. 638).

Based on the record as a whole, the Court concludes that the ALJ's findings are supported by substantial evidence in the record as a whole. First, as noted by the Court's description of the opinion of Dr. Schneider, he opined that plaintiff's symptomatology was related to her head injury, however, as noted by the ALJ, even in "the six years prior to [plaintiff's] accident, however, she earned only $5931" ( see Tr. 635). The ALJ also noted that plaintiff's total "lifetime earnings amount to $21, 451" (Tr. 634). The ALJ inferred from this evidence that "factors other than her alleged impairments affect her ability to maintain full-time employment, " additionally noting that plaintiff's overuse of Valium, as reported to Dr. Biss, may have been "contributing to her lack of motivation to work" ( see Tr. 635 ( citing Tr. 328)).

The ALJ may "draw inferences logically flowing from the evidence." Sample v. Schweiker, 694 F.2d 639, 642 (9th Cir. 1999) ( citing Beane v. Richardson, 457 F.2d 758 (9th Cir. 1972); Wade v. Harris, 509 F.Supp. 19, 20 (N.D. Cal. 1980)). However, an ALJ may not speculate. See SSR 86-8, 1986 SSR LEXIS 15 at *22. The Court concludes that the ALJ's inference that plaintiff's work history suggests a lack of motivation to work, as does her overuse of her Valium prescription even though she indicated that it did not work, are "inferences logically flowing from the evidence." See Sample, supra, 694 F.2d at 642 (citations omitted). The Court also concludes that this finding, supported by substantial evidence in the record, provides a specific and legitimate reason for failing to credit fully the opinions of Dr. Schneider, who opined that plaintiff's symptomatology was related to her head injury, as opposed to her lack of motivation to work.

Similarly, as alluded to previously, Dr. Schneider appeared not to credit fully the MMPI-2 results which indicated that plaintiff was overreporting symptoms, exaggerating, and endorsing infrequent, unlikely and unrealistic psychiatric symptoms ( see Tr. 375). Instead, Dr. Schneider appeared to opine that these results merely reflected further symptoms of plaintiff's head injury ( see id. ). The ALJ, however, unlike Dr. Schneider, also had evidence of plaintiff's results from the Structured Inventory of Malingered Symptomatology (SIMS), the results of which "far outweigh[ed] the conservative cutoff score" ( see Tr. 330). As discussed in detail previously, this objective test used to detect malingering was evaluated thoroughly by Dr. Biss ( see id. ). Dr. Biss reviewed plaintiff's subscale scores, and found that they "revealed that her inflated SIMS Total Score was due to overreporting of unlikely symptoms for: (1) neurological impairment, (2) Affective Disorder, (3) Low IQ, and (4) Amnesia" ( see id. ). Therefore, Dr. Biss, in contrast to Dr. Schneider, opined that plaintiff "likely overreported her level of distress and level of cognitive impairment, " and "strongly suspected" malingering ( see Tr. 331).

The ALJ is responsible for resolving ambiguities and conflicts in the medical evidence. Reddick v. Chater, 157 F.3d 715, 722 (9th Cir. 1998) ( citing Andrews v. Shalala, 53 F.3d 1035, 1039 (9th Cir. 1995)). In this matter, unlike Drs. Biss and Schneider, the ALJ had access to both plaintiff's SIMS test results as well as her MMPI-2 test results. Both of these objective tests indicated that plaintiff was overreporting her symptoms and was exaggerating, endorsing infrequent, unlikely and unrealistic psychiatric symptoms ( see Tr. 330, 375).

For the stated reasons, the Court concludes that the ALJ's finding that the opinions of Dr. Schneider were "inconsistent with the objective testing (SIMS and MMPI-2) showing that the claimant exaggerated her symptoms and was likely malingering" is a finding based on substantial evidence in the record as a whole. The Court also concludes that this finding entails specific and legitimate rationale for failing to credit fully the opinion of Dr. Schneider.

The ALJ also found that Dr. Schneider's opinion was inconsistent with evidence of inconsistent statements about plaintiff's abilities. Despite plaintiff's report to Dr. Schneider that she attempted not be around more than one person and that she suffered from social anxiety ( see Tr. 372), as noted by the ALJ, plaintiff reportedly maintained the ability to shop in stores 2 to 3 times a month and she reported that she attends social events ( see Tr. 631 ( citing Ex. 3E, 11F/5)). These findings are based on substantial evidence in the record ( see Tr. 147, 328). For example, plaintiff reported to Dr. Biss that she consumed "alcohol infrequently at social events" ( see Tr. 328).

Similarly, the ALJ found that Dr. Schneider's opinion was not consistent "with recent evidence showing improved function with medication when taken as prescribed" ( see Tr. 638). This finding, too, is based on substantial evidence in the record as a whole, as will be discussed in further detail in the Court's discussion of the ALJ's rejection of the opinion of Dr. Kay Stradinger, Psy.D, see infra, section 1.C.

For the reasons stated herein and based on the record as a whole, the Court concludes that the ALJ provided specific and legitimate rationale for his failure to credit fully all the opinions from Dr. Schneider. See Reddick v. Chater, 157 F.3d 715, 725 (9th Cir. 1998) ( citing Magallanes v. Bowen, 881 F.2d 747, 751 (9th Cir. 1989)); see also Lester v. Chater, 81 F.3d 821, 830-31 (9th Cir. 1996) ( citing Andrews v. Shalala, 53 F.3d 1035, 1043 (9th Cir. 1995); Murray v. Heckler, 722 F.2d 499, 502 (9th Cir. 1983)).

C. Dr. Kay L. Stradinger, Psy.D., examining doctor

Dr. Stradinger examined plaintiff in August 2013, approximately five months before the ALJ's written decision ( see Tr. 821-32, 641). Dr. Stradinger noted plaintiff's report that she first had depressive symptoms when she was 16 ( see Tr. 821). She also noted plaintiff's report that her depression was better managed "now because she was started on mood stabilizers six months ago and she thinks it helps her mood a little" ( see id. ). She also noted plaintiff's report that "her OCD is not so bad now" ( see Tr. 822). Dr. Stradinger noted plaintiff's report that "she has social disorder" ( see id. ). Further indicating potential reliance on plaintiff's self-report, Dr. Stradinger also noted plaintiff's report that "memory loss is her biggest concern now'" ( see id. ).

Dr. Stradinger noted plaintiff's report that plaintiff "does not work well with others" and that "she has issues with authority and always has" had such issues ( see Tr. 824). Dr. Stradinger noted plaintiff's opinion that "she believes she has no problems with abuse of or dependence on prescription medications, " ( see id. ), in contrast to plaintiff's report to Dr. Biss that "she often over uses the medication, " Valium ( see Tr. 328), and to other reports of improper use of medications ( see, e.g., Tr. 508) and in contrast to Dr. Biss' opinion that plaintiff had a likelihood of "abuse [of] prescribed medications" ( see Tr. 332).

Dr. Stradinger performed a mental status examination ( see Tr. 825-27). She noted that plaintiff "came in stating she had a migraine and that the lights in the waiting room and this room were terrible for her[, y]et when the examiner asked her if we could turn the overhead lights off, she said, no, thank you, ' because it wouldn't help" ( see Tr. 825). Dr. Stradinger opined that plaintiff's thought processes were goal directed, her voice was clear for understanding, and she spoke with an average rate, rhythm, volume, and of an above average amount ( see id. ).

Regarding plaintiff's memory performance, Dr. Stradinger indicated that plaintiff "could complete a five - digit span forward and a five - digit span backward on the first trials for low average and high average performances respectively" ( see Tr. 826). Plaintiff was able to "complete a six - digit span forward on the second trial and a seven - digit span forward on the first trial, " although she was unable to complete a six - digit span backward on one trial ( see id. ). Regarding recent memory, plaintiff was able to repeat three out of three simple words on the first trial, and after about seven minutes, plaintiff successfully recalled two out of three words and with a clue could recall the third word, which Dr. Stradinger opined was a "slight impairment" ( see id. ). Regarding plaintiff's memory for the past, plaintiff was able to report her birthday, phone number, and address without difficulty ( see id. ).

Dr. Stradinger opined that plaintiff demonstrated below average fund of knowledge and information as she "could name the current U.S. president and name two of the three previous to him, but not in the correct order, [and] could name 2/2 states bordering Washington" ( see id. ). Plaintiff refused to attempt serial sevens, however, plaintiff "attempted serial 3s starting with 20 and correctly calculated backward to 11 before she stopped, saying, This irritates me because it should be so simple'" ( see id. ). Plaintiff was able to complete three simple arithmetic problems correctly ( see id. ).

Regarding her concentration, plaintiff demonstrated the ability to spell WORLD correctly both forward and backward ( see id. ). Regarding plaintiff's abstract thinking, Dr. Stradinger indicated as follows:

[Plaintiff] said No ifs, ands, or buts means, "No, it's not happening." When presented with The grass is always greener on the other side she asked if you have to agree, then she said it meant, "They want something better than theirs." She said Rome wasn't built in a day means, "It takes time."

(Tr. 826).

Regarding testing on similarities and differences, plaintiff "said a dog and lion are alike because they are animals and different because they are from the dog and cat family" ( see Tr. 827). Dr. Stradinger opined that plaintiff's judgment and insight were fair to adequate ( see id. ). She noted that if plaintiff "found a letter on the sidewalk she would put it in the mailbox [and] [if] she was in a movie theater and smoke broke out, suggesting fire, she would get out and pull the fire alarm" ( see id. ).

Dr. Stradinger diagnosed plaintiff with bipolar disorder not otherwise specified and indicated that this diagnosis was "per history" and also diagnosed PTSD, similarly indicating that this diagnosis was "per history" ( see id. ). Dr. Stradinger also diagnosed plaintiff with panic disorder with agoraphobia ( see id. ). She opined that plaintiff's global assessment of functioning (GAF) was 51 ( see id. ).

With respect to her discussion and prognosis, Dr. Stradinger indicated that plaintiff had "good memory for having applied for SSI and immediately was asking how long this would be and remembering that she had to do a bunch of puzzles and things in the last evaluation she was required to go to" ( see id. ). Dr. Stradinger indicated that plaintiff "tended not to go into specific details regarding her past unless specifically asked, so given the limited time today the specific criteria for some of her many diagnoses could not be pinpointed such as PTSD, ADHD, and bipolar disorder" ( see id. ). Dr. Stradinger indicated that "it appears she has had treatment in the past according to the records and those providers have previously diagnosed her according to criteria over time" ( see id. ).

Dr. Stradinger noted that plaintiff expressed little concern about OCD or ADHD or social phobia at her appointment and "stated that she was independent for all ADL's yet also stated that she needs her child with her to drive or to grocery shop, indicating some inconsistency or ambivalence" ( see id. ). Dr. Stradinger indicated that although plaintiff stated that she mostly was concerned with memory loss, plaintiff "seemed to do quite well for memory in the exam today, however" ( see id. ).

Regarding her functional assessment and medical source statement, Dr. Stradinger indicated that plaintiff was "capable of managing her funds, based on her cognitive level of function" ( see Tr. 828). Dr. Stradinger opined that plaintiff had "marked impairment for accepting instructions from supervisors given her personality and perhaps related also to anxiety" ( see id. ). She also opined that plaintiff had "marked impairment in interacting with coworkers and the public given her problems with social skills and relationships" ( see id. ). She opined that plaintiff had "moderate impairment for performing work activities on a consistent basis without special or additional instruction, " related to plaintiff's problems with recall and problems with persistence, as well as potentially being related to anxiety ( see id. ). Dr. Stradinger opined that plaintiff had "marked persistence for maintaining regular attendance in the workplace and completing a normal workday/workweek without interruptions from her anxiety and depression" ( see id. ). Finally, she opined that plaintiff had "marked impairment for dealing with the usual stress encountered in the workplace, " related to problems with coping skills, which may be triggered by anxiety or depression ( see id. ).

The ALJ included the following discussion in his written opinion:

Kay Stradinger, Psy.D., performed a consultative examination with the claimant in August 2013. She diagnosed the claimant with bipolar disorder, NOS, per history; posttraumatic stress disorder (PTSD), per history; panic disorder with Agoraphobia; cluster B traits and rule out diagnoses of attention deficit hyperactivity disorder (ADHD) and opioid dependence in a controlled setting (internal citation to Ex. 34F/7). She opined in one instance that the claimant is capable of managing her funds and in another that she is not. She opined further that the claimant is unimpaired for performing simple and repetitive tasks. The claimant has a marked impairment for accepting instructions from supervisors and for interacting with coworkers and the general public. The claimant has a moderate impairment for performing work activities on a consistent basis without special or additional instruction. The claimant also has a marked impairment in persistence for maintaining regular attendance in the workplace, for completing a normal workday and for dealing with the usual stress encountered in the workplace (internal citations to Ex. 34F/7-8, Ex. 35F/1-3). Dr. Stradinger's opinion is given little weight except for her assessment of the claimant's ability to perform simple work, which is consistent with her performance on a mental status examination and squares with objective intelligence testing. Otherwise the opinion is inconsistent with that of Dr. Moore who reviewed the entire medical evidence record. Dr. Stradinger reviewed only the CBS crisis plan and notes from Peace Mental Health providers (internal citation to Ex. 34F/1). Dr. Stradinger provided contradictory statements as to whether the claimant was capable of managing her own benefits. In addition, Dr. Stradinger's assessment does not square with Dr. Biss' findings of potential malingering and Valium abuse. Dr. Stradinger also does not account for evidence showing improvement with symptomatology with therapy and medication and evidence of medication non-compliance.

(Tr. 637).

Despite Dr. Stradinger's August 2013 opinion of plaintiff's multiple marked limitations, the ALJ discussed how plaintiff's symptoms actually improved over time when she was taking her medications as prescribed, which the ALJ also found that she did not always do. For example, the ALJ noted as follows:

The claimant's statements to Brent Francisco, an ARNP, or treating mental health provider, on February 2008, are seemingly incongruous with a person who alleges onset of depression during the previous month. She told Mr. Francisco that Cymbalta is helping, with no bad side effects. She reported decreased pain allowing her to go to the park more often with her children. She stated things were going well overall. Mr. Francisco observed she was well groomed and estimated her global assessment of functioning (GAF) score to be 55 (internal citation to Ex. 20F/9-10). In mental status examinations in March 2012 and January 2013, the claimant's mood, affect, judgment, insight, memory, attention, concentration and thought content were all within normal limits (internal citation to Ex. 45F/33, 41). In February 2013, the claimant reported she was doing okay' with her bipolar depression (internal citation to Ex. 45F/27).

(Tr. 631 (footnote omitted)).

The ALJ's findings that plaintiff's mental health symptoms improved with medication and that she demonstrated test results within normal limits following mental status examinations are supported by substantial evidence in the record ( see id. ). On February 14, 2008, approximately one year before the relevant period of time for the ALJ's decision (January 29, 2009), Mr. Brent Francisco, an ARNP, noted that plaintiff indicated that she was getting about six hours of sleep; that she had not noticed much difference in her depression, anxiety or pain management; and that she was not experiencing any bad side effects from her medications ( see Tr. 395). On May 5, 2008, at her next appointment, according to the treatment record of Mr. Francisco, plaintiff "says Cymbalta is helping and [she] has a bit less pain, [and] is getting out to the park with the kids" ( see Tr. 394). Plaintiff also reported that "overall things going okay" ( see id. ). This treatment record supports the ALJ's finding that plaintiff's mental health improved when she took her prescribed medication and that this improvement occurred even before the relevant period of time for the ALJ's written decision ( see id. ).

Also as reported by Mr. Francisco, and as noted by the ALJ, plaintiff reported in February, 2009 "that her mood is better with the recent increase of Cymbalta [and plaintiff] [said] she feels happier and is having an easier time dealing with her kids" ( see Tr. 490). Mr. Francisco opined that plaintiff was demonstrating a better range of affect than on her prior visit ( see id. ). Similarly, Mr. Francisco reported the subsequent month that plaintiff reported that "things are better" and that she had a bit more energy, and her sleep was okay ( see Tr. 489). Mr. Francisco opined that plaintiff's mood was a bit better ( see id. ). On April 20, 2009, plaintiff indicated that "things are going good [and that the] only hangup is with her coverage for Cymbalta" ( see Tr. 487). Plaintiff also indicated that her "anxiety is under good control, mood as improved and sleep is good" ( see id. ). As indicated by Mr. Francisco, plaintiff reported that "she has even noticed she is feeling better on rainy days" ( see id. ). On May 26, 2009, plaintiff similarly reported to Mr. Francisco that "everything is going fairly well" ( see Tr. 485). Plaintiff indicated that her "meds are doing fine" ( see id. ). As noted by the ALJ, during plaintiff's "course of treatment with Mr. Francisco in the first half of 2009, her estimated GAF score increased from 51 to 56" ( see Tr. 632 (internal citation to 485, 487, 489-91)).

Similarly, in February, 2010, plaintiff indicated that her medications "have been working better" ( see Tr. 553). At the same appointment, she indicated that medication and counseling both had helped her in the past ( see id. ). On August 2, 2010, plaintiff described "her recent moods as happy, " although the staff member noted that plaintiff did not appear happy ( see Tr. 618). Less than a month later, on August 24, 2010, plaintiff "reported that she has been feeling really good lately due to her new [boyfriend]" and had gone camping over the previous weekend and reporting having a good time ( see Tr. 616). On this occasion, the same staff member indicated that plaintiff "presented as happy, nicely groomed (makeup, jewelry), and was quite talkative" ( see id. ). The staff member indicated also that the tone of plaintiff's voice was stronger than it had been before ( see id. ).

Also as noted by the ALJ, in August, 2013, at plaintiff's most recent consultative examination prior to the ALJ's decision, plaintiff "state[d] her OCD is not so bad now, " and she noted her intensive outpatient weekly treatment ( see Tr. 822). At the same appointment, plaintiff indicated that her depression was "better managed now because she was started on mood stabilizers six months ago" ( see Tr. 821; see also Tr. 631). In February 2013, as noted by the ALJ, plaintiff reported that she was "doing okay" with her bipolar depression ( see Tr. 962).

For the reasons stated, the Court concludes that the ALJ's finding that such "evidence shows improvement in depressive symptoms with medication" is a finding based on substantial evidence in the record as a whole ( see Tr. 633). The Court also concludes that the ALJ's finding of improvement of plaintiff's symptoms when she takes her prescribed medications supports the ALJ's failure to credit fully the opinion from Dr. Stradinger in August, 2013 regarding plaintiff's marked limitations from her mental health impairments. The ALJ's finding that "Dr. Stradinger also does not account for evidence showing improvement in symptomatology with therapy and medication and evidence of medication noncompliance" is a finding based on substantial evidence in the record as a whole. In addition, this is a specific and legitimate reason for failing to credit fully the opinions of Dr. Stradinger.

The ALJ also found that the opinion of Dr. Stradinger was inconsistent with the opinion "of Dr. Moore who reviewed the entire medical evidence record, " noting that "Dr. Stradinger reviewed only the CBS crisis plan and notes from Piece Mental Health providers" ( see Tr. 637 (internal citation to Ex. 34F/1)). Plaintiff argues against this rationale, noting that Dr. Margaret Moore only opined that plaintiff's mental health impairments did not meet one of the listed impairments ( see ECF No. 12, p. 18 ( citing Tr. 677-86)). However, as noted by defendant, "Dr. Stradinger's assessment of multiple marked limitations essentially was that plaintiff's impairments met or equaled a listing and [as such] was clearly inconsistent with Dr. Moore's assessment" ( see ECF No. 16, p. 11 ( citing Tr. 828)). This finding by the ALJ also supports the ALJ's failure to credit fully the opinion of Dr. Stradinger.

Finally, the ALJ noted an inconsistency within the opinion of Dr. Stradinger, as well as noting that Dr. Stradinger's opinion did not appear to account for any potential malingering, as found by Dr. Biss ( see Tr. 637). These findings are supported by substantial evidence in the record as a whole, and they provide some support for the ALJ's failure to credit fully the opinion of Dr. Stradinger.

For the reasons stated and based on the record as a whole, the Court concludes that the ALJ provided sufficient specific and legitimate rationale for failing to credit fully the opinions of Dr. Stradinger. See Reddick v. Chater, 157 F.3d 715, 725 (9th Cir. 1998) ( citing Magallanes v. Bowen, 881 F.2d 747, 751 (9th Cir. 1989)); see also Lester v. Chater, 81 F.3d 821, 830-31 (9th Cir. 1996) ( citing Andrews v. Shalala, 53 F.3d 1035, 1043 (9th Cir. 1995); Murray v. Heckler, 722 F.2d 499, 502 (9th Cir. 1983)).

D. Drs. Jerry Gardner, Ph.D. and Eugene Fierman, M.D., state agency, nonexamining medical consultants

Plaintiff complains that the ALJ failed to credit fully opinions from state agency, non-examining medical consultants, Drs. Gardner and Fierman ( see ECF No. 12, pp. 14-16). In his written decision, the ALJ discusses the opinion of Dr. Gardner, whose opinion was affirmed by Dr. Fierman ( see Tr. 638).

The ALJ credited a portion of Dr. Gardner's opinion, but gave much of Dr. Gardner's opinion "little weight" ( see Tr. 638). The ALJ relied in part on his reasoning that plaintiff "need not be limited to reading simple sentences as objective test scores reveal a high school graduate level on reading fluency measures, a 9.1 grade level on the letter - word identification subtests and reading comprehension at 11.3 grade level, and [plaintiff] herself reported that she dropped out of high school because it was too easy" ( see id. ( citing Exhibit 19F/3)). This finding by the ALJ is supported by substantial evidence in the record, as Dr. Schneiders' 2008 report indicates that plaintiff "left school during the 10th grade because she was bored" ( see Tr. 374), his 2003 report indicates that she reported that in high school she "was bored because it was too easy'" ( see Tr. 378) and plaintiff reported to Dr. Biss in 2008 that "when she placed effort into her behaviors she was capable of receiving A's" ( see Tr. 329).

The ALJ also specified that limitations with respect to "contact with coworkers are not warranted nor are additional limitations in the skill level of work as the record shows [plaintiff]'s subjective complaints of difficulties in social environments and difficulties with concentration, persistence or pace were found to be minimally credible based on SIMS and MMPI-2 testing" ( see Tr. 638).

As discussed by the Court previously, see supra, section 1.A, Dr. Biss noted that plaintiff's "Total Score for the SIMS was a 38, therefore far outweighing the conservative cutoff score of 16" to detect malingering ( see Tr. 330). Dr. Biss noted that plaintiff "over reported symptoms in every category except psychosis" ( see id. ). Similarly, also as noted previously, the MMPI-2 conducted by Dr. Schneider also "indicates over-reporting of symptoms, " and as noted by Dr. Schneider, plaintiff "was endorsing infrequent, unlikely and unrealistic psychiatric symptoms" ( see Tr. 375).

The ALJ "may reject the opinion of a non-examining physician by reference to specific evidence in the medical record." Sousa v. Callahan, 143 F.3d 1240, 1244 (9th Cir. 1998) ( citing Gomez v. Chater, 74 F.3d 967, 972 (9th Cir. 1996)); Andrews, supra, 53 F.3d at 1041). Here, the ALJ specified multiple aspects of the record when failing to credit fully all of the opinion from state agency non-examining doctor, Dr. Gardner, whose opinion was affirmed by Dr. Fierman ( see Tr. 638). Based on the record as a whole, the Court concludes the ALJ did not err when evaluating the medical evidence provided by Dr. Gardner, which was affirmed by Dr. Fierman. See Sousa, supra, 143 F.3d at 1244 ( citing Gomez v. Chater, 74 F.3d at 972).

(2) Did the ALJ provide clear and convincing reasons to discredit plaintiff's testimony?

Plaintiff argues that the ALJ failed to provide clear and convincing rationale for his failure to credit fully plaintiff's allegations and testimony ( see ECF No. 12, pp. 19-23). Plaintiff contends that the ALJ "did not give specificity to what testimony he found not credible and what evidence showed the testimony was not credible" ( see id., p. 20). Although plaintiff acknowledges that the ALJ relied in part on objective testing results and opinion evidence demonstrating plaintiff's exaggeration, plaintiff argues that "the record shows [plaintiff's] performance on testing was consistent with a head injury and her personality disorder" ( see id. ( citing Tr. 332, 275). Regardless of the cause of plaintiff's exaggerated testimony, the fact that plaintiff over-reported symptoms and provided exaggerated testimony is clear and convincing rationale for the failure to credit fully her allegations. Defendant additionally argues that even if the Court concludes that the ALJ committed legal error in the evaluation of plaintiff's credibility, "the Court should uphold the ALJ's credibility determination" (ECF No. 16, p. 13 ( citing Carmickle v. Comm'r. Soc. Sec. Admin., 533 F.3d 1155, 1162 (9th Cir. 2008)).

If the medical evidence in the record is not conclusive, sole responsibility for resolving conflicting testimony and questions of credibility lies with the ALJ. Sample v. Schweiker, 694 F.2d 639, 642 (9th Cir. 1999) ( citing Waters v. Gardner, 452 F.2d 855, 858 n.7 (9th Cir. 1971) ( Calhoun v. Bailar, 626 F.2d 145, 150 (9th Cir. 1980)). An ALJ is not "required to believe every allegation of disabling pain" or other non-exertional impairment. Fair v. Bowen, 885 F.2d 597, 603 (9th Cir. 1989) ( citing 42 U.S.C. § 423(d)(5)(A) (other citations and footnote omitted)). The ALJ may "draw inferences logically flowing from the evidence." Sample, supra, 694 F.2d at 642 ( citing Beane v. Richardson, 457 F.2d 758 (9th Cir. 1972); Wade v. Harris, 509 F.Supp. 19, 20 (N.D. Cal. 1980)). However, an ALJ may not speculate. See SSR 86-8, 1986 SSR LEXIS 15 at *22.

Nevertheless, the ALJ's credibility determinations "must be supported by specific, cogent reasons." Reddick v. Chater, 157 F.3d 715, 722 (9th Cir. 1998) ( citing Bunnell v. Sullivan, 947 F.2d 341, 343, 346-47 (9th Cir. 1991) ( en banc )). The ALJ may consider "ordinary techniques of credibility evaluation, " including the claimant's reputation for truthfulness and inconsistencies in testimony regarding symptoms, and may also consider a claimant's daily activities, and "unexplained or inadequately explained failure to seek treatment or to follow a prescribed course of treatment." Smolen v. Chater, 80 F.3d 1273, 1284 (9th Cir. 1996) (citations omitted).

If an ALJ rejects the testimony of a claimant once an underlying impairment has been established, the ALJ must support the rejection "by offering specific, clear and convincing reasons for doing so." Smolen, supra, at 1284 ( citing Dodrill v. Shalala, 12 F.3d 915, 918 (9th Cir.1993)); see also Reddick, supra, 157 F.3d at 722 ( citing Bunnell v. Sullivan, supra, 947 F.2d at 343, 346-47).

Here, the ALJ offered multiple reasons for failing to credit fully plaintiff's allegations and testimony, such as her non-compliance with medical treatment and improvement in mental health symptoms when compliant with medication; lack of motivation to work; evidence of limited effort and exaggeration of symptoms; and inconsistent statements. The evidence of limited effort and exaggeration of symptoms, such as the SIMS report, the MMPI-2 test results, and the opinion by Dr. Biss that plaintiff was not putting forth full effort, was discussed previously in the context of the medical evidence, see supra, section 1 ( see also, e.g., Tr. 328, 330-31, 375). The Court also notes the opinion of Dr. Mary White, M. D. that plaintiff seemed "to make a poor effort during both the interview and the exam" ( see Tr. 455-56). Likewise, regarding the ALJ's finding that plaintiff exhibited a lack of motivation to work even prior to her head injury, the Court already has discussed this finding and has found that it is based on substantial evidence in the record as a whole, see supra, section 1.B. The Court also concludes that plaintiff's lack of effort on testing and evidence of exaggeration, as well as her demonstrated lack of motivation to work both support the ALJ's failure to credit fully plaintiff's allegations and testimony.

Similarly, some of the evidence regarding the ALJ's finding that plaintiff was not compliant with her prescribed treatment already has been discussed in the context of the medical evidence, see supra, section 1. The Court also discussed already in detail the ALJ's finding of plaintiff's improvement in symptomatology when compliant with her prescribed treatment, see supra, section 1.C. In addition, the Court also notes here that on April 22, 2008, plaintiff "reported that she has been advised to attend counseling, but has been noncompliant" ( see Tr. 328). As noted, plaintiff reported that although her Valium prescription does not help, "she often over uses the medication" ( see id. ). Likewise, regarding plaintiff's recommended physical therapy, the ALJ noted that in "September 2012, the claimant initiated physical therapy but canceled the subsequent appointment and no - showed at her next appointment and was discharged from her physical therapy plan" ( see Tr. 629 ( citing Ex. 42F/1, 4) (also noting that plaintiff's "doctors recommended continued exercise rather than restricted activity levels")). Again, the Court concludes that the ALJ's finding that plaintiff was non-compliant with prescribed treatment is a finding based on substantial evidence in the record as a whole. As already discussed, the Court also concludes that the ALJ's finding that plaintiff's symptoms improved when she was compliant with prescribed treatment is a finding based on substantial evidence in the record as a whole, see supra, section 1.C. These findings also support the ALJ's failure to credit fully plaintiff's allegations and testimony.

Finally, the ALJ also noted a plethora of inconsistent statements by plaintiff. As noted previously, see supra, section 1.B, plaintiff reported not wanting to leave the house and reported avoiding being around more than one person, but also "reported consuming alcohol infrequently at social events" ( see Tr. 328, 372). Although on March 28, 2009 plaintiff reported that "she is unable to do almost anything; she lies around most of the time, " and at her first hearing on December 17, 2010, plaintiff testified that she does not do household chores because it hurts too much ( see Tr. 658), in May, 2012, plaintiff reported being a caregiver for her mother because her mother had broken her leg ( see Tr. 902).

On December 17, 2010, plaintiff testified that she cannot use a cane or walker to get around because it hurts her wrists ( see Tr. 656), and at her second administrative hearing on December 6, 2013, plaintiff testified that although her "wrists are still too weak to do most things, " ( see Tr. 695), she testified that she now was using a cane and had been using the cane for "a few years at least" ( see Tr. 692).

The ALJ noted that in the April 2008 evaluation by Dr. Biss, plaintiff reported discomfort when sitting and moving, however the doctor observed that plaintiff did not express discomfort or move excessively during the 90 minute interview ( see Tr. 633 ( citing Tr. 327)). This finding by the ALJ is supported by substantial evidence in the record, as Dr. Biss' report includes the following: "[Plaintiff] reported discomfort when sitting and moving. However, she did not express discomfort or move excessively when interviewed in the 1.5 hour time" (Tr. 327). Similarly, the ALJ noted that plaintiff testified at her first administrative hearing in December, 2010 that she could only sit for about "a half hour" ( see Tr. 664), however in January, 2009, plaintiff reported to Mr. Francisco that she "has been doing nothing but sits" ( see Tr. 391; see also Tr. 633).

The ALJ also noted that plaintiff reported to Dr. White in March, 2009 "that her 11-year-old son does the cooking in the home because she cannot stand" ( see Tr. 455), however plaintiff reported to Ms. Ellen Walker on April 19, 2010, that her son "refuses to do chores around the house" ( see Tr. 518).

The ALJ also discussed plaintiff's inconsistent statements regarding her drug and alcohol use ( see Tr. 634). For example, as noted by the ALJ, plaintiff went to the emergency room on February 17, 2010 complaining of rectal pain and stated that she was "overusing her methocarbamol and other medications" and reported that she also was "drinking alcohol for her pain and state[d] that she drinks every single day" ( see Tr. 508). The ER physician noted that plaintiff "was quite upset that I would not give her anything further for pain" ( see Tr. 509). On February 23, 2010, plaintiff admitted using methamphetamine in the past at age 16 ( see Tr. 544). The ALJ also noted that, in addition to the report to Dr. Biss that plaintiff overused her Valium ( see Tr. 328), plaintiff admitted in June, 2011 "that she did have a problem with prescription narcotic abuse in the past, and was getting medications from family members in addition to doctors" ( see Tr. 945). Similarly, on June 20, 2011 plaintiff "admitted to taking more pain meds than she needed to and this kept her in bed" ( see Tr. 853).

In contrast to these admissions by plaintiff, as noted by the ALJ, in September 2011, plaintiff "stated that she rarely drinks alcohol and denied any toxic habits" ( see Tr. 634 ( citing Tr. 843)); and, in the following month, on October 19, 2011 plaintiff denied any "history of drinking or drug abuse" ( see Tr. 848). Similarly, in May, 2012, plaintiff indicated that she drank "alcohol on occasion and denied any current or previous illicit [] substance use or abuse including marijuana" ( see Tr. 900). However, in August, 2013, plaintiff stated that she had used marijuana in the past ( see Tr. 824).

For the stated reasons, the Court concludes that the ALJ's finding that plaintiff made inconsistent statements is a finding based on substantial evidence in the record as a whole. The Court also concludes that this finding supports the ALJ's failure to credit fully plaintiff's allegations and testimony.

The Ninth Circuit has "recognized that harmless error principles apply in the Social Security Act context." Molina v. Astrue, 674 F.3d 1104, 1115 (9th Cir. 2012) ( citing Stout v. Commissioner, Social Security Administration, 454 F.3d 1050, 1054 (9th Cir. 2006) (collecting cases)). The court noted that "several of our cases have held that an ALJ's error was harmless where the ALJ provided one or more invalid reasons for disbelieving a claimant's testimony, but also provided valid reasons that were supported by the record." Id. (citations omitted). The Ninth Circuit noted that "in each case we look at the record as a whole to determine [if] the error alters the outcome of the case." Id. The court also noted that the Ninth Circuit has "adhered to the general principle that an ALJ's error is harmless where it is inconsequential to the ultimate nondisability determination.'" Id. ( quoting Carmickle v. Comm'r Soc. Sec. Admin., 533 F.3d 1155, 1162 (9th Cir. 2008)) (other citations omitted). The court noted the necessity to follow the rule that courts must review cases "without regard to errors' that do not affect the parties' substantial rights.'" Id. at 1118 ( quoting Shinsheki v. Sanders, 556 U.S. 396, 407 (2009) ( quoting 28 U.S.C. § 2111) (codification of the harmless error rule)).

The Court concludes that even if the ALJ committed an error in the evaluation of plaintiff's credibility, any such error is harmless error. The ALJ included multiple findings based on substantial evidence in the record that support his failure to credit fully plaintiff's allegations and testimony. The Court concludes that the ALJ provided clear and convincing reasons for his failure to credit fully plaintiff's credibility.

CONCLUSION

Based on the stated reasons and the relevant record, the Court ORDERS that this matter be AFFIRMED pursuant to sentence four of 42 U.S.C. § 405(g).

JUDGMENT should be for defendant and the case should be closed.


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