Coates v. Commissioner of Social Security Administration

1
2
3
4
5
6
7
8
9
10
11
12
13
14
15
16
17
18
19
20
21
22
23
24
25
26
27
28
WO
IN THE UNITED STATES DISTRICT COURT
FOR THE DISTRICT OF ARIZONA
Adrianne Coates,
Plaintiff,
v.
Frank Bisignano, Commissioner of Social
Security Administration,
Defendant.
No. CV-26-00675-PHX-SHD (DMF)
REPORT AND RECOMMENDATION
TO THE HONORABLE SHARAD H. DESAI, UNITED STATES DISTRICT
JUDGE:
This matter is on referral to the undersigned for further proceedings and a report and
recommendation pursuant to 28 U.S.C. § 636(b)(1) and Rules 72.1 and 72.2 of the Local
Rules of Civil Procedure (Doc. 10).1
At issue is the denial of Plaintiff’s application for disability insurance benefits under
the Social Security Act (“Act”). On February 2, 2026, Adrianne Coates (“Plaintiff” and/or
“Coates”) filed a Complaint with this Court through counsel (Doc. 1). In the Complaint,
Plaintiff seeks review of the denial of benefits (Id.). After careful review of the record,
including Plaintiff’s Opening Brief (Doc. 12), Defendant’s Answering Brief (Doc. 14),
Plaintiff’s Reply Brief (Doc. 15), and the administrative record (Doc. 11-1 at 3-173
1 Citation to the record as “Doc.” indicates documents as displayed in the official Court
electronic document filing system maintained by the District of Arizona under Case No.
CV-26-00675-PHX-SHD (DMF).
Case 2:26-cv-00675-SHD Document 16 Filed 06/26/26 Page 1 of 19

- 2 -
1
2
3
4
5
6
7
8
9
10
11
12
13
14
15
16
17
18
19
20
21
22
23
24
25
26
27
28
hereafter, “R.”), it is recommended that the final decision of the Commissioner of Social
Security (“Commissioner”) be vacated and this matter be remanded to the Social Security
Administration for further administrative proceedings.
I. BACKGROUND
On January 19, 2023, Plaintiff filed an application for disability benefits under Title
II and Part A of Title XVIII of the Act (R. at 204-07). Plaintiff’s application was denied
initially on December 18, 2023 (R. at 107-15) and upon reconsideration on May 30, 2024
(R. at 116-25). Plaintiff thereafter requested a hearing, which was held on December 17,
2024 (R. at 87-106). On January 31, 2025, Administrative Law Judge (“ALJ”) Paul
Isherwood issued a decision finding Plaintiff not disabled (R. at 17-27). On December 2,
2025, the Appeals Council denied Plaintiff’s request for review, at which point the ALJ’s
January 31, 2025, decision became final (R. at 1-3). Plaintiff thereafter filed the Complaint
initiating this matter (Doc. 1).
In the January 31, 2025, decision, the ALJ determined that Plaintiff met the insured
requirements of the Act through June 30, 2025 (R. at 20). After considering Plaintiff’s
certified earnings record and subsequent reports, the ALJ found that Plaintiff engaged in
no substantial gainful activity since the alleged onset date, December 14, 2022 (R. at 20).
The ALJ found that Plaintiff has the following severe impairments: glaucoma, spinal fusion
and carpal tunnel syndrome (CTS) (R. at 20). The ALJ further found that Plaintiff did not
have an impairment or combination of impairments that met or medically equaled the
severity of one of the listed impairments in 20 C.F.R. § 404, Subpart P, Appendix 1 (R. at
20).
In analyzing Plaintiff’s residual functional capacity (“RFC”), the ALJ considered
the statements of Plaintiff and her husband as well as prior administrative medical findings
and medical opinions (R. at 20-26). The ALJ determined that Plaintiff’s statements
concerning the intensity, persistence, and limiting effects of her symptoms were not
consistent with the medical evidence (R. at 21) and determined that Plaintiff’s husband’s
statements were not supported by the medical evidence of record (R. at 24). The ALJ
Case 2:26-cv-00675-SHD Document 16 Filed 06/26/26 Page 2 of 19

- 3 -
1
2
3
4
5
6
7
8
9
10
11
12
13
14
15
16
17
18
19
20
21
22
23
24
25
26
27
28
further considered the prior administrative medical findings and the medical opinions of
agency medical consultants as well as Douglas Denney, PA-C; Vanousheh Ghandhari,
DPM; and Camille Hylton, M.D. (R. at 24-26). Ultimately, the ALJ concluded that
Plaintiff “has the residual functional capacity to perform light work as defined in 20 CFR
404.1567(b) except with the following additional limitations: The claimant can frequently
handle, finger and feel” (R. at 20).
The ALJ next found that Plaintiff is capable of performing past relevant work as a
legal assistant or legal secretary (R. at 26). In making the determination, the ALJ
considered vocational expert testimony that Plaintiff has past relevant work as a legal
assistant (DOT 119.267-026) and as a legal secretary (DOT 201.362-010). The vocational
expert testified that Plaintiff’s legal assistant work was actually and generally performed
at the light level and classified as skilled work with an SVP of 7 and that Plaintiff’s legal
secretary work was actually and generally performed at the sedentary level and classified
as skilled work with an SVP of 6 (R. at 26). The ALJ compared Plaintiff’s RFC to the
physical and mental demands of Plaintiff’s past relevant work and found that Plaintiff is
able to perform the work as actually and generally performed (R. at 26). The ALJ therefore
concluded that Plaintiff was not under a disability as defined in the Act from the alleged
onset date of December 14, 2022, through January 31, 2025 (R. at 27).
II. LEGAL FRAMEWORK
A district court reviews only the issues raised by the party challenging an ALJ’s
decision. See Lewis v. Apfel, 236 F.3d 503, 517 n.13 (9th Cir. 2001). If the court finds that
the ALJ’s decision was not based on substantial evidence or was based on legal error, the
court may set aside the decision. Orn v. Astrue, 495 F.3d 625, 630 (9th Cir. 2007).
Substantial evidence requires “more than a mere scintilla but less than a preponderance”
and should be enough evidence “as a reasonable mind might accept as adequate to support
a conclusion.” Id. (quoting Burch v. Barnhart, 400 F.3d 676, 679 (9th Cir. 2005)). An
ALJ’s decision should be upheld if “evidence is susceptible to more than one rational
interpretation,” but a district court should “consider the entire record as a whole and may
Case 2:26-cv-00675-SHD Document 16 Filed 06/26/26 Page 3 of 19

- 4 -
1
2
3
4
5
6
7
8
9
10
11
12
13
14
15
16
17
18
19
20
21
22
23
24
25
26
27
28
not affirm simply by isolating a specific quantum of supporting evidence.” Id. (quotations
and citations omitted).
In determining whether a claimant is disabled under the Act, the ALJ must follow a
five-step sequential evaluation process. 20 C.F.R. § 404.1520(a). First, the ALJ must
determine whether a claimant is participating in substantial gainful activity. 20 C.F.R.
§ 404.1520(a)(4)(i). If so, the claimant is not disabled. Id. Second, the ALJ determines
whether a claimant has a “severe medically determinable physical or mental impairment.”
20 C.F.R. § 404.1520(a)(4)(ii). If not, the claimant is not disabled. Id. Third, the ALJ
determines whether the claimant’s impairment meets or equals a listing in Appendix 1 of
Subpart P of 20 C.F.R. § 404. 20 C.F.R. § 404.1520(a)(4)(iii). If so, the ALJ will find the
claimant disabled, and the inquiry ends. Id. If the ALJ must proceed to step four, the ALJ
determines whether the claimant’s RFC allows the claimant to perform past relevant work.
20 C.F.R. § 404.1520(a)(4)(iv). If so, the claimant is not disabled. Id. If the ALJ must
proceed to step five, the ALJ determines whether the claimant’s RFC allows the claimant
to perform other work. 20 C.F.R. § 404.1520(a)(4)(v). If so, the claimant is not disabled.
Id. If not, the claimant is disabled. Id.
III. ANALYSIS
A. Summary of the Parties’ Positions
1. Plaintiff’s Opening Brief (Doc. 12)
Plaintiff challenges the ALJ’s determination with respect to step two and step four
of the sequential evaluation. Specifically, Plaintiff contends that the ALJ failed to account
for Plaintiff’s foot impairments before concluding that Plaintiff could perform light work
as defined in 20 C.F.R. § 404.1567(b) (Doc. 12 at 2). Plaintiff states that she suffers from
“several toe and foot impairments that have caused painful limitations in her ability to stand
and walk” (Id. at 7). Plaintiff explains that “she underwent two left foot surgeries involving
screw fixation of the foot” and by 2023 x-ray imaging revealed “‘significant joint space
narrowing’ of both feet with evidence of arthritis” (Id.). Plaintiff further states that “[s]he
exhibited limited range of motion, crepitus, pain with palpation, and antalgic gait related
Case 2:26-cv-00675-SHD Document 16 Filed 06/26/26 Page 4 of 19

- 5 -
1
2
3
4
5
6
7
8
9
10
11
12
13
14
15
16
17
18
19
20
21
22
23
24
25
26
27
28
to her bilateral foot impairments” (Id. at 7-8).
Plaintiff’s podiatrist treated Plaintiff’s foot impairments and eventually
recommended surgery for her left foot and toe (Id. at 8). In November 2023, Plaintiff’s
podiatrist performed the surgery “involving removal of previous painful hardware and left
great toe joint fusion with plates, screw fixation, and bone graft harvesting” as well as “a
surgical shortening of the metatarsal bone” (Id.). Plaintiff states that her foot impairments
improved somewhat following the procedure but “had ongoing painful symptoms related
to both feet” (Id.). Plaintiff’s podiatrist opined that Plaintiff suffered from “‘severe end
stage osteoarthritis’ of the right great toe” and that Plaintiff’s foot impairments limited
Plaintiff’s ability to stand and walk (Id.).
Plaintiff argues that, despite the medical opinion of Plaintiff’s podiatrist, the ALJ
“almost entirely failed to acknowledge—much less adequately evaluate—Coates’ bilateral
foot impairments” (Id. at 9). Plaintiff contends that the ALJ failed to identify Plaintiff’s
foot impairments as “severe” at step two of the sequential evaluation and that the ALJ’s
RFC analysis at step four omitted discussion of Plaintiff’s foot impairments (Id. at 9-14).
Plaintiff notes that light work as defined by 20 C.F.R. § 404.1567(b) requires “a good deal
of walking or standing” which is inconsistent with the medical opinion of Plaintiff’s
treating podiatrist (Id. at 10-11). Upon review, Plaintiff raises three issues for the Court’s
consideration. First, Plaintiff argues that the ALJ’s decision is inconsistent with Social
Security Ruling (“SSR”) 85-28, 1985 WL 56856, *2, which requires an ALJ to identify
impairments at step two that “significantly limit the ability to perform basic work
activities” (Id. at 9). Second, Plaintiff argues that the ALJ erred by failing to provide clear
and convincing reasons to discount Plaintiff’s symptom testimony (Id. at 10-11). Third,
Plaintiff argues that the ALJ erred by failing to address the medical opinion of Plaintiff’s
treating podiatrist relating to Plaintiff’s foot limitations (Id. at 11-14). Plaintiff argues that
remand is necessary for the ALJ to evaluate her foot related impairments (Id. at 14). For
relief, Plaintiff asks the Court to reverse the ALJ’s January 31, 2025, decision, remand the
matter for a new administrative hearing, award Plaintiff costs and reasonable attorney’s
Case 2:26-cv-00675-SHD Document 16 Filed 06/26/26 Page 5 of 19

- 6 -
1
2
3
4
5
6
7
8
9
10
11
12
13
14
15
16
17
18
19
20
21
22
23
24
25
26
27
28
fees under the Equal Access to Justice Act, 20 U.S.C. § 2412(d) (“EAJA”), and grant other
and further relief as the Court deems just and proper (Id.).
2. The Commissioner’s Answering Brief (Doc. 14)
In the Answering Brief, the Commissioner argues that the ALJ’s January 31, 2025,
decision is supported by substantial evidence and should be affirmed (Doc. 14). The
Commissioner first argues that Plaintiff alleged only problems with her vision and right
hand at the hearing (Id. at 3). The Commissioner also contends that the ALJ reasonably
considered and discussed all of Plaintiff’s impairments (Id. at 3-7). The Commissioner
concedes that the ALJ “did not explicitly discuss Plaintiff’s foot conditions at step two of
the sequential evaluation” but argues that any omission was harmless because the ALJ fully
discussed Plaintiff’s foot limitations at step four (Id. at 6). Regarding step four, the
Commissioner cites several portions of the ALJ’s decision and argues that the portions
reflect that the ALJ adequately considered Plaintiff’s foot limitations (Id. at 4-6). The
Commissioner argues:
In his decision, the ALJ considered reports relating to Plaintiff’s foot
conditions, explaining that a medical examination showed “no shooting pain
down the surface of the leg with hip flexion and knee extension in the sitting
position with dorsiflexion of the foot.” AR 22, 458-59. The consultative
examination report cited by the ALJ showed that Plaintiff had normal gait,
could “stand, walk to the examination table, get onto and sit on the
examination table without assistance and without difficulty,” and could “lift
each foot off the ground and stand without assistance and demonstrated
appropriate balance including walking on heels, toes and tandem walking.”
AR 458. The consultative examiner even reported that Plaintiff had normal
muscle bulk and tone “without atrophy” in the lower extremities, which
showed intact (“5/5”) strength. AR 459. On examination, Plaintiff had “[n]o
shooting pain down the surface of the leg.” AR 459. “When objective
medical evidence in the record is inconsistent with the claimant’s subjective
testimony, the ALJ may indeed weigh it as undercutting such testimony.”
Smartt, 53 F.4th at 498 (italics in original). The ALJ thus discounted any
alleged limitation related to foot symptoms.
Additionally, the ALJ considered and discussed other evidence relating to
Plaintiff’s foot conditions, including a medical opinion provided by
Plaintiff’s podiatrist, Vanousheh Ghandhari, DPM. AR 25, 513-15. Dr.
Case 2:26-cv-00675-SHD Document 16 Filed 06/26/26 Page 6 of 19

- 7 -
1
2
3
4
5
6
7
8
9
10
11
12
13
14
15
16
17
18
19
20
21
22
23
24
25
26
27
28
Ghandhari opined that Plaintiff could only walk 1-2 city blocks without rest
or significant pain and had other limitations. AR 513-14. However, the ALJ
reasonably explained that Dr. Ghandhari’s opinion was “less persuasive
because it [was] not supported by relevant objective medical evidence,
inconsistent with evidence from other medical sources, and contradicted by
other factors.” AR 25; see 20 C.F.R. § 404.1520c(b)(2) (explaining that the
two most important factors in determining an opinion’s persuasiveness are
supportability and consistency). For example, the ALJ pointed out that
although Dr. Ghandhari opined Plaintiff had lifting limitations, he provided
no medical explanation for such limitations. AR 25, 514 (Dr. Ghandhari
providing no citation or explanation for lifting restrictions). The ALJ also
explained that Dr. Ghandhari’s opinion was inconsistent with other evidence,
including reports that Plaintiff went for walks, performed exercises with
weights, drove a car when going places, shopped in stores, prepared daily
meals, and had no problems performing activities of self-care. AR 25, 260-
62, 277-79. In sum, contrary to Plaintiff’s assertion, the ALJ reasonably
considered Plaintiff’s foot conditions.
(Doc. 14 at 5-6). Thus, the Commissioner argues that substantial evidence supports the
ALJ’s decision and asks the Court to affirm the ALJ’s January 31, 2025, decision (Id. at 6-
7).
3. Plaintiff’s Reply Brief (Doc. 15)
In her Reply Brief, Plaintiff first contests the Commissioner’s suggestion that
Plaintiff did not adequately raise her foot impairments at the hearing (Doc. 15 at 2-4).
Plaintiff states that at the hearing, Plaintiff’s attorney explicitly raised her foot impairments
as a basis for her disability and engaged in a lengthy discussion of the impairments causing
the ALJ to ask Plaintiff’s attorney to abbreviate his remarks (Id. at 2-4). Plaintiff also
argues that the passages cited by the Commissioner do not reflect that the ALJ adequately
addressed Plaintiff’s foot impairments because the ALJ discussed Plaintiff’s foot
impairments in passing and addressed only the identified severe impairments—glaucoma,
spinal fusion, and carpal tunnel syndrome (Id. at 4-5). Plaintiff reasons that such incidental
mentions of her foot impairments do not satisfy the ALJ’s obligation to address each of
Plaintiff’s impairments (Id.).
///
///
Case 2:26-cv-00675-SHD Document 16 Filed 06/26/26 Page 7 of 19

- 8 -
1
2
3
4
5
6
7
8
9
10
11
12
13
14
15
16
17
18
19
20
21
22
23
24
25
26
27
28
B. Failure to Identify Plaintiff’s Alleged Foot Impairments as “Severe”
1. Legal Standard
In step two of the analysis, the ALJ must assess “whether the claimant has a
medically severe impairment or combination of impairments that significantly limits his
ability to do basic work activities.” Webb v. Barnhart, 433 F.3d 683, 686 (9th Cir. 2005)
(citing 20 C.F.R. § 404.1520(a)(4)(ii)). The finding of a severe impairment is necessary
for the ALJ to find the claimant disabled. Webb, 433 F.3d at 686. This step is a “de
minimis screening device used to dispose of groundless claims.” Smolen v. Chater, 80
F.3d 1273, 1290 (9th Cir. 1996) (citing Bowen v. Yuckert, 482 U.S. 137, 153-54 (1987)).
Therefore, “properly denying a claim at step two requires an unambiguous record showing
only minimal limitations.” Glanden v. Kijakazi, 86 F.4th 838, 843 (9th Cir. 2023).
For an impairment to be severe, the claimant must show that it significantly limits
his ability to perform basic work activities for twelve consecutive months or more. 20
C.F.R. § 404.1509; see Edlund v. Massanari, 253 F.3d 1152, 1159-60 (9th Cir. 2001).
“Basic work activities” are defined as “the abilities and aptitudes necessary to do most
jobs.” 20 C.F.R. § 404.1522(b). A diagnosis of a particular impairment does not entitle
the claimant to a finding of limitation. Young v. Sullivan, 911 F.2d 180, 183-84 (9th Cir.
1990); see Molina v. Astrue, 674 F.3d 1104, 1112 (9th Cir. 2012) (holding that an ALJ is
not required to believe the disabling effect of every symptom “or else disability benefits
would be available for the asking”).
The ALJ must consider Plaintiff’s subjective symptoms in determining severity. 20
C.F.R. § 404.1529(d). When evaluating subjective symptom testimony, an ALJ must first
find objective medical evidence demonstrating an impairment that could reasonably cause
a claimant’s symptoms. Smolen, 80 F.3d at 1281-82; 20 C.F.R. § 404.1529(a)-(b). A
claimant’s subjective testimony alone will not establish a disability, and an ALJ will
determine whether the claimant’s alleged limitations are consistent with medical sources.
20 C.F.R. § 404.1529(a). Once the claimant has shown such an impairment, if there is no
evidence of malingering, the ALJ may reject a claimant’s symptom testimony only if the
Case 2:26-cv-00675-SHD Document 16 Filed 06/26/26 Page 8 of 19

- 9 -
1
2
3
4
5
6
7
8
9
10
11
12
13
14
15
16
17
18
19
20
21
22
23
24
25
26
27
28
ALJ offers “specific findings stating clear and convincing reasons for doing so.” Smolen,
80 F.3d at 1283-84. The specific, clear, and convincing reasons must be supported by
evidence in the record. Brown-Hunter v. Colvin, 806 F.3d 487, 488-89 (9th Cir. 2015).
Although an ALJ may consider the objective medical evidence, the ALJ may not use a lack
of such evidence as the sole basis to discount a claimant’s testimony. Bray v. Comm’r of
Soc. Sec. Admin., 554 F.3d 1219, 1227 (9th Cir. 2009); 20 C.F.R. § 404.1529(c)(2). An
ALJ may also consider a “claimant’s daily activities, inconsistencies in testimony,
effectiveness or adverse side effects of any pain medication, and relevant character
evidence.” Orteza v. Shalala, 50 F.3d 748, 750 (9th Cir. 1995); 20 C.F.R.
§ 404.1529(c)(3). If “the evidence is susceptible to more than one rational
interpretation[,]” the Court will uphold the ALJ’s conclusion. Tommasetti v. Astrue, 533
F.3d 1035, 1038 (9th Cir. 2008) (superseded by statute on other grounds).
Moreover, the finding of an impairment as non-severe at step two does not remove
it from consideration in a claimant’s disability determination. Buck v. Berryhill, 869 F.3d
1040, 1048-49 (9th Cir. 2017). Indeed, the ALJ must consider all of a claimant’s medically
determinable impairments, including those that are not severe in determining a claimant’s
RFC. 20 C.F.R. § 404.1545(a)(2).
Nevertheless, a district court will not reverse the decision of an ALJ for an error that
is harmless. Burch, 400 F.3d at 679. Error is harmless if it “was inconsequential to the
ultimate nondisability determination.” Stout v. Comm’r, Soc. Sec. Admin., 454 F.3d 1050,
1055 (9th Cir. 2006) (citations omitted). The party asserting error bears the burden of
showing prejudice resulting from the error. McLeod v. Astrue, 640 F.3d 881, 888 (9th Cir.
2011).
2. Plaintiff’s Testimony
In connection with her disability claim, Plaintiff completed a function report
regarding the effects of her symptoms (R. at 259-67). In the report, Plaintiff stated that
“the osteoarthritis I have in my feet cause[s] pain when standing still and walking for long
lengths of time” (R. at 259). Plaintiff specified that her foot pain impaired her sleep and
Case 2:26-cv-00675-SHD Document 16 Filed 06/26/26 Page 9 of 19

- 10 -
1
2
3
4
5
6
7
8
9
10
11
12
13
14
15
16
17
18
19
20
21
22
23
24
25
26
27
28
that she cannot “sit or stand too long for food preparation” (R. at 260, 261). Plaintiff further
stated that her osteoarthritis, among other things, prevented her from “sitting for hours at
[her] desk” (R. at 266-67).
At the hearing, Plaintiff’s attorney explained that Plaintiff’s osteoarthritis, among
other things, limits Plaintiff to sedentary work and prevents Plaintiff from performing her
past work (R. at 93-94). However, Plaintiff provided no further symptom testimony at the
hearing (see R. at 94-101).
3. Opinion of Vanousheh Ghandhari, DPM
Dr. Ghandhari opined that Plaintiff suffered from “severe end stage osteoarthritis”
of the “right great toe” which caused pain while standing or walking (R. at 518). Dr.
Ghandhari further opined that Plaintiff was limited to walking one to two city blocks before
needing to rest and elevate her foot (R. at 513), Plaintiff was limited to standing no more
than 30 minutes at one time and sitting no more than one to two hours at a time (R. at 518),
Plaintiff would require three unscheduled breaks during an eight-hour work day (R. at 518),
and Plaintiff would likely be absent four or more days per month due to her impairments
(R. at 518). Dr. Ghandhari also opined that Plaintiff suffers from moderate pain, Plaintiff
is not a malinger, and Plaintiff’s pain frequently interferes with attention and concentration
(R. at 517).
4. The ALJ’s Findings
The ALJ found that Plaintiff “has the following severe impairments: glaucoma,
spinal fusion and carpal tunnel syndrome (CTS)” (R. at 20).
5. Discussion
The record reflects that the ALJ was sufficiently put on notice of Plaintiff’s foot
impairments. As Plaintiff points out, her attorney discussed Platiniff’s foot related
impairments at the hearing and argued that Plaintiff’s osteoarthritis limits Plaintiff to
performing sedentary work (R. at 94). Moreover, Plaintiff stated in the function report that
her osteoarthritis interfered with her ability to stand, walk, and sit (R. at 259-67).
Further, the Commissioner appears to concede that the ALJ erred at step two of the
Case 2:26-cv-00675-SHD Document 16 Filed 06/26/26 Page 10 of 19

- 11 -
1
2
3
4
5
6
7
8
9
10
11
12
13
14
15
16
17
18
19
20
21
22
23
24
25
26
27
28
sequential evaluation. In the Commissioner’s Answering Brief, the Commissioner states:
Admittedly, the ALJ did not explicitly discuss Plaintiff’s foot conditions at
step two of the sequential evaluation. AR 20. But any omission was
harmless. Even where an ALJ errs in not including an impairment as
“severe” at step two, if “step two was decided in [the claimant’s] favor,” the
claimant “could not possibly have been prejudiced” and any “alleged error is
therefore harmless and cannot be the basis for a remand.” Buck v. Berryhill,
869 F.3d 1040, 1049 (9th Cir. 2017). For example, an ALJ’s failure to
identify an impairment as severe at step two is harmless where the “ALJ
considered any limitations posed” by the impairment at a later step of the
sequential evaluation. Lewis v. Astrue, 498 F.3d 909, 911 (9th Cir. 2007).
Here, although the ALJ did not explicitly discuss foot conditions at step two,
the ALJ fully considered them later in the sequential evaluation, as just
discussed. AR 22 (discussing medical report showing normal gait and no
foot abnormalities), 25 (discussing treating podiatrist’s medical opinion). In
short, the ALJ fully considered and discussed Plaintiff’s pertinent
impairments.
(Doc. 14 at 6). The Commissioner is correct that the ALJ harmlessly erred at step two.
Although the ALJ failed to discuss Plaintiff’s foot impairments at step two, it is
undisputed that the ALJ decided step two in Plaintiff’s favor. Indeed, the ALJ determined
that Plaintiff has several other severe impairments (R. at 20) and continued to discuss steps
three and four of the sequential evaluation (R. at 20-27). Accordingly, any error at step
two is harmless. See Buck, 869 F.3d at 1049 (concluding that an ALJ’s error at step two
was harmless because “step two was decided in [the plaintiff’s] favor” and the plaintiff
“could not possibly have been prejudiced”).
C. Plaintiff’s Symptom Testimony
Plaintiff argues that the ALJ erred by failing to provide clear and convincing reasons
for rejecting Plaintiff’s symptom testimony regarding Plaintiff’s osteoarthritis (Doc. 12 at
10-11).
1. Legal Standard
The Ninth Circuit has “established a two-step analysis for determining the extent to
which a claimant’s symptom testimony must be credited[.]” Trevizo v. Berryhill, 871 F.3d
664, 678 (9th Cir. 2017). First, the ALJ must determine “whether the claimant has
Case 2:26-cv-00675-SHD Document 16 Filed 06/26/26 Page 11 of 19

- 12 -
1
2
3
4
5
6
7
8
9
10
11
12
13
14
15
16
17
18
19
20
21
22
23
24
25
26
27
28
presented objective medical evidence of an underlying impairment which could reasonably
be expected to produce the pain or other symptoms alleged.” Id. (quoting Garrison v.
Colvin, 759 F.3d 995, 1014-15 (9th Cir. 2014)). At the first step, the claimant “need only
show that [the impairment] could reasonably have caused some degree of the symptom.”
Id. The claimant need not “produce objective medical evidence of the pain or fatigue itself,
or the severity thereof.” Id.
If the claimant satisfies the first step, and there is no evidence of malingering, the
ALJ may reject the claimant’s testimony “only by offering specific, clear and convincing
reasons for doing so.” Id. The specific, clear, and convincing reasons must be supported
by evidence in the record. Brown-Hunter v. Colvin, 806 F.3d 487, 488-89 (9th Cir. 2015).
Although an ALJ may consider the objective medical evidence, the ALJ may not use a lack
of such evidence as the sole basis to discount a claimant’s testimony. Bray v. Comm’r of
Soc. Sec. Admin., 554 F.3d 1219, 1227 (9th Cir. 2009); 20 C.F.R. § 404.1529(c)(2). An
ALJ may also consider a “claimant’s daily activities, inconsistencies in testimony,
effectiveness or adverse side effects of any pain medication, and relevant character
evidence.” Orteza v. Shalala, 50 F.3d 748, 750 (9th Cir. 1995); 20 C.F.R. § 404.1529(c)(3).
If “the evidence is susceptible to more than one rational interpretation[,]” the Court will
uphold the ALJ’s conclusion. Tommasetti v. Astrue, 533 F.3d 1035, 1038 (9th Cir. 2008)
(superseded by statute on other grounds).
2. Plaintiff’s Testimony
As discussed above, Plaintiff completed a function report stating that “the
osteoarthritis I have in my feet cause[s] pain when standing still and walking for long
lengths of time” (R. at 259). Plaintiff specified that her foot pain impaired her sleep and
that she cannot “sit or stand too long for food preparation” (R. at 260, 261). Plaintiff further
stated that her osteoarthritis, among other things, prevented her from “sitting for hours at
[her] desk” (R. at 266-67).
At the hearing, Plaintiff’s attorney explained that Plaintiff’s osteoarthritis, among
other things, limits Plaintiff to sedentary work and prevents Plaintiff from performing her
Case 2:26-cv-00675-SHD Document 16 Filed 06/26/26 Page 12 of 19

- 13 -
1
2
3
4
5
6
7
8
9
10
11
12
13
14
15
16
17
18
19
20
21
22
23
24
25
26
27
28
past work (R. at 93-94). However, Plaintiff provided no further symptom testimony at the
hearing (see R. at 94-101).
3. The ALJ’s Findings
Regarding Plaintiff’s symptom testimony, the ALJ stated that Plaintiff “alleges
glaucoma, spinal fusion and CTS” (R. at 21). The ALJ’s findings did not address Plaintiff’s
reported foot limitations (see R. at 21-23).
4. Discussion
The ALJ did not provide clear and convincing reasons supported by substantial
evidence to discount Plaintiff’s reported foot limitations. As Plaintiff correctly points out,
the ALJ failed to address Plaintiff’s reported limitations in her feet and toes in the
discussion about her symptom testimony (Doc. 12 at 10-11). The ALJ addressed only
Plaintiff’s allegations of “glaucoma, spinal fusion and CTS” (R. at 21-23).
The ALJ must engage in a two-step process to evaluate subjective symptom
testimony. Here, the ALJ engaged in no analysis of Plaintiff’s reported foot limitations.
Plaintiff stated in a functional report that the osteoarthritis in her foot interferes with her
ability to stand, walk, and sit and Plaintiff’s attorney explained that Plaintiff’s osteoarthritis
limits Plaintiff to sedentary work (R. at 93, 259-67). Yet, the ALJ’s decision addresses
only Plaintiff’s reported glaucoma, spinal fusion and CTS.
In the Answering Brief, the Commissioner argues that the ALJ properly discounted
any alleged limitation related to Plaintiff’s foot symptoms because the ALJ relied on
medical examination which showed “no shooting pain down the surface of the leg with hip
flexion and knee extension in the sitting position with dorsiflexion of the foot” (Doc. 14 at
4-5). Yet the cited portion relates to the ALJ’s discussion of Plaintiff’s alleged symptoms
due to a spinal fusion rather than foot impairments (R. at 22). Moreover, medical evidence
relating to pain experienced while “in the sitting position with dorsiflexion of the foot”
does not address Plaintiff’s alleged symptoms while standing or walking. Because the ALJ
failed to properly address Plaintiff’s reported foot limitations, the ALJ did not provide
specific, clear, and convincing reasons supported by substantial evidence for discounting
Case 2:26-cv-00675-SHD Document 16 Filed 06/26/26 Page 13 of 19

- 14 -
1
2
3
4
5
6
7
8
9
10
11
12
13
14
15
16
17
18
19
20
21
22
23
24
25
26
27
28
Plaintiff’s symptom testimony. See SSR 96-8p2 1996 WL 374184, *5 (In assessing RFC,
the adjudicator must consider limitations and restrictions imposed by all of an individual’s
impairments, even those that are not ‘severe.’”).
Further, the ALJ’s error is not harmless. If Plaintiff’s testimony regarding her foot
limitations was credited, Plaintiff’s RFC would have included additional limitations.
Accordingly, the error was not inconsequential to the ultimate nondisability determination.
See Stout, 454 F.3d at 1055.
It is recommended that the ALJ’s January 31, 2025, decision be vacated and this
matter be remanded for consideration of Plaintiff’s reported foot limitations.
D. Medical Source Opinion
Plaintiff argues that the ALJ erred by rejecting the opinion of her treating podiatrist,
Vanousheh Ghandhari, DPM (Doc. 12-13).
1. Legal Standard
For disability benefits claims filed before March 27, 2017, Social Security
Administration (“SSA”) regulations classified medical opinion sources into three types: 1)
treating physicians (who treat a claimant), 2) examining physicians (who examine but do
not treat a claimant), and 3) non-examining physicians (who do not examine or treat a
claimant). Lester, 81 F.3d at 830. An ALJ was instructed to give more weight to treating
medical sources than non-examining sources due to a treating physician’s heightened
familiarity with a claimant’s condition. 20 C.F.R. § 404.1527(a)(2). If the ALJ declined
to give controlling weight to a treating physician’s contradicted opinion, the ALJ had to
provide “specific and legitimate reasons supported by substantial evidence” for rejecting
that source’s opinion. Murray v. Heckler, 722 F.2d 499, 502 (9th Cir. 1983).
For disability benefits claims filed after March 27, 2017, including the application
2 SSRs “are binding on all components of the Social Security Administration” and
“represent precedent[ial] final opinions and orders and statements of policy and
interpretations” of the SSA. 20 C.F.R. § 402.35(b)(1); see also Heckler v. Edwards, 465
U.S. 870, 873 n.3 (1984) (noting that an SSR “may be superseded, modified, or revoked
by later legislation, regulations, court decisions or rulings”). Although SSRs do not carry
the force of law, “[t]hey are binding on ALJs.” Quang Van Han v. Bowen, 882 F.2d 1453,
1457 n.6 (9th Cir. 1989) (citing Paulson v. Bowen, 836 F.2d 1249, 1252 n.2 (9th Cir.1988));
see also Heckler, 465 U.S. at 873 n.3.
Case 2:26-cv-00675-SHD Document 16 Filed 06/26/26 Page 14 of 19

- 15 -
1
2
3
4
5
6
7
8
9
10
11
12
13
14
15
16
17
18
19
20
21
22
23
24
25
26
27
28
in the present case3, SSA regulations instruct an ALJ not to “defer or give any specific
evidentiary weight, including controlling weight, to any medical opinion(s) or prior
administrative medical finding(s), including those from [a claimant’s] medical sources.”
20 C.F.R. § 404.1520c. Instead, an ALJ should determine the persuasiveness of each
medical opinion using the following factors: 1) supportability, 2) consistency, 3)
relationship with the claimant, 4) specialization, and 5) any other relevant factors. Id. The
SSA has explained that supportability and consistency are the most important factors in
evaluating an opinion’s persuasiveness, and the ALJ must articulate how he considered
both factors. Id.; Revisions to Rules Regarding the Evaluation of Medical Evidence, 82
Fed. Reg. 5853 (Jan. 18, 2017) (codified at 20 C.F.R. § 404). “Supportability concerns
how ‘a medical source supports a medical opinion’ with relevant evidence, while
consistency concerns how ‘a medical opinion is consistent with the evidence from other
medical and nonmedical sources.’” Kitchen v. Kijakazi, 82 F.4th 732, 739-40 (9th Cir.
2023) (quoting Woods v. Kijakazi, 32 F.4th 785, 792 (9th Cir. 2022))
In 2022, the Ninth Circuit held that the 2017 SSA regulations no longer require an
ALJ to provide specific and legitimate reasons for rejecting a medical source opinion.
Woods, 32 F.4th at 787. Instead, an ALJ decision to discount a medical source opinion
must be supported by substantial evidence. Id. As the Ninth Circuit explained, “[e]ven
under the new regulations, an ALJ cannot reject an examining or treating doctor’s opinion
as unsupported or inconsistent without providing an explanation supported by substantial
evidence.” Id. at 792.
3. Opinion of Vanousheh Ghandhari, DPM
As discussed above, Dr. Ghandhari opined that Plaintiff suffered from “severe end
stage osteoarthritis” of the “right great toe” which caused pain while standing or walking
(R. at 518). Dr. Ghandhari further opined that Plaintiff was limited to walking one to two
city blocks before needing to rest and elevate her foot (R. at 513), Plaintiff was limited to
standing no more than 30 minutes at one time and sitting no more than one to two hours at
3 Plaintiff filed her application on January 19, 2023 (R. at 204).
Case 2:26-cv-00675-SHD Document 16 Filed 06/26/26 Page 15 of 19

- 16 -
1
2
3
4
5
6
7
8
9
10
11
12
13
14
15
16
17
18
19
20
21
22
23
24
25
26
27
28
a time (R. at 518), Plaintiff would require three unscheduled breaks during an eight-hour
work day (R. at 518), and Plaintiff would likely be absent four or more days per month due
to her impairments (R. at 518). Dr. Ghandhari also opined that Plaintiff suffers from
moderate pain, Plaintiff is not a malinger, and Plaintiff’s pain frequently interferes with
attention and concentration (R. at 517).
Dr. Ghandhari also reported that Plaintiff could occasionally lift less than ten pounds
(R. at 514). At the hearing, Plaintiff’s attorney explained that Dr. Ghandhari’s “opinion
would be primarily relevant to . . . standing and walking” (R. at 100-01).
4. The ALJ’s Findings
In considering Dr. Ghandhari’s opinion, the ALJ acknowledged the diagnosis that
Plaintiff suffered from “right hallux rigidus with a fair prognosis” (R. at 25). The ALJ
further acknowledged Dr. Ghandhari’s opinion that Plaintiff “had pain with walking,”
Plaintiff could “sit[] 6-7 hours and stand and/or walk[] 1-2 hours in an 8-hour workday,”
and Plaintiff “did not need an assistive device to ambulate” (R. at 25). The ALJ also
considered Dr. Ghandhari’s opinion that Plaintiff could occasionally lift less than 10
pounds (R. at 25). However, the ALJ found Dr. Ghandhari’s opinion “less persuasive
because it not supported by relevant objective medical evidence, inconsistent with evidence
from other medical sources, and contradicted by other factors” (R. 25). The ALJ reasoned:
First, Dr. Ghandhari is a podiatrist opining on lifting limits, which are based
on her right hallux rigidus and not degenerative disc disease. Second, the
objective medical evidence does not support this opinion. A study of the
lumbar spine dated October 10, 2023 revealed posterior fusion hardware and
interbody spacer at L4-5 intact without loosening, there is 4 mm
anterolisthesis of L4 and L5, posterior alignment otherwise appears normal,
normal alignment, mild disc space narrowing at L5-S1 and sacrum and
coccyx intact (Exhibit 9F/1). A study of the cervical spine revealed
degenerative disc disease and the findings included moderate disc space
narrowing at C5-6 and C6-7, no fracture, normal soft tissues, normal
alignment and the odontoid process appeared intact and lateral masses are
symmetric (Exhibit 9F/2). A study of the thoracic spine revealed no acute
findings (Exhibit 9F/3). Additionally, the claimant also reported she is able
to independently care for her personal needs, do light cooking, light
housework, goes for a walk, sometimes exercises with weights, run errands
Case 2:26-cv-00675-SHD Document 16 Filed 06/26/26 Page 16 of 19

- 17 -
1
2
3
4
5
6
7
8
9
10
11
12
13
14
15
16
17
18
19
20
21
22
23
24
25
26
27
28
as needed and attend physical therapy and doctor’s appointments, as
scheduled (Exhibits 4E, 6E and 13E). She reported she is able to drive,
attends church, able to shop in stores and by computer for groceries, home
goods and occasional clothing. She reported she is able to pay bills, count
change, handle a savings account and use a checkbook. She reported she does
not read or sew anymore because her eyes get tired; however, is able to watch
TV, go to the movies and take are of houseplants once in a while. The
claimant also reported she spends time with others in person, on the phone,
by email, texting and mail (Exhibit 6E). Accordingly, the undersigned finds
[Dr. Ghandhari’s] opinion less persuasive.
(R. at 25).
4. Discussion
The ALJ’s decision to discount Dr. Ghandhari’s opinion regarding Plaintiff’s foot
impairments is not supported by substantial evidence. Although a portion of the ALJ’s
decision is devoted to Dr. Ghandhari’s opinion, the ALJ failed to articulate how he
considered the supportability and consistency of Dr. Ghandhari’s opinion regarding
Plaintiff’s foot impairments. Instead, the ALJ focused on Dr. Ghandhari’s opinion that
Plaintiff could occasionally lift less than ten pounds (R. at 25). The ALJ discounted Dr.
Ghandhari’s opinion regarding lifting because “Dr. Ghandhari is a podiatrist opining on
lifting limits, which are based on her right hallux rigidus and not degenerative disc disease”
(R. at 25). The ALJ further explained that Dr. Ghandhari’s opinion is not supported
because studies of Plaintiff’s lumbar, cervical, and thoracic spine revealed generally
normal findings (R. at 25). Yet, the cited spine studies are inapposite with respect to Dr.
Ghandhari’s opinion about Plaintiff’s foot impairments and associated walking and
standing limitations. Further, Plaintiff’s reported activities do not necessarily negate Dr.
Ghandhari’s opinion and the ALJ failed to explain how Plaintiff’s activities contradict Dr.
Ghandhari’s opinion. For example, Plaintiff’s ability to “pay bills, count change, handle a
savings account and use a checkbook” or to “spend[] time with others in person, on the
phone, by email, texting and mail” in no way contradicts Dr. Ghandhari’s opinion
regarding Plaintiff’s foot impairments (see R. at 25). Additionally, Plaintiff’s reported
ability to “independently care for her personal needs, do light cooking, light housework,
Case 2:26-cv-00675-SHD Document 16 Filed 06/26/26 Page 17 of 19

- 18 -
1
2
3
4
5
6
7
8
9
10
11
12
13
14
15
16
17
18
19
20
21
22
23
24
25
26
27
28
goes for a walk, sometimes exercises with weights, run errands as needed and attend
physical therapy and doctor’s appointments” does not necessarily contradict Dr.
Ghandhari’s opinion. See Reddick v. Chater, 157 F.3d 715, 722 (9th Cir. 1998) (“claimants
should not be penalized for attempting to lead normal lives in the face of their limitations”);
Ghanim v. Colvin, 763 F.3d 1154, 1165 (9th Cir. 2014) (no indication that plaintiff’s home
basic activities were transferable to work or conflicted with reported symptoms).
Thus, substantial evidence does not support the ALJ’s decision to discredit Dr.
Ghandhari’s opinion regarding Plaintiff’s foot impairments. In discrediting Dr.
Ghandhari’s opinion regarding Plaintiff’s foot impairments, the ALJ erred. If the ALJ
credited Dr. Ghandhari’s testimony regarding Plaintiff’s foot limitations, Plaintiff’s RFC
would have included additional limitations. Accordingly, the error was not inconsequential
to the ultimate nondisability determination. See Stout, 454 F.3d at 1055. Upon remand,
the ALJ should consider Dr. Ghandhari’s opinion regarding Plaintiff’s foot impairments.
IV. CONCLUSION
The ALJ failed to support the rejection of Plaintiff’s symptom testimony and Dr.
Ghandhari’s opinion regarding Plaintiff’s foot impairments with substantial evidence.
Moreover, Dr. Ghandhari’s opinion and Plaintiff’ symptom testimony if credited would
have altered the ALJ’s RFC analysis. Thus, the errors were not inconsequential to the
ultimate nondisability determination. It is therefore recommended that the final decision
of the Commissioner be vacated and this matter be remanded for further administrative
proceedings.
Accordingly,
IT IS RECOMMENDED that the January 31, 2025, decision of ALJ Paul
Isherwood (R. at 17-27) be vacated.
IT IS FURTHER RECOMMENDED that this case be remanded to the Social
Security Administration for further administrative proceedings.
This recommendation is not an order that is immediately appealable to the Ninth
Circuit Court of Appeals. Any notice of appeal pursuant to Rule 4(a)(1) of the Federal
Case 2:26-cv-00675-SHD Document 16 Filed 06/26/26 Page 18 of 19

- 19 -
1
2
3
4
5
6
7
8
9
10
11
12
13
14
15
16
17
18
19
20
21
22
23
24
25
26
27
28
Rules of Appellate Procedure should not be filed until entry of the District Court’s
judgment. The parties shall have fourteen days from the date of service of a copy of this
recommendation within which to file specific written objections with the Court. See 28
U.S.C. § 636(b)(1); Fed. R. Civ. P. 6, 72. The parties shall have fourteen days within which
to file responses to any objections. Failure to file timely objections to the Magistrate
Judge’s Report and Recommendation may result in the acceptance of the Report and
Recommendation by the District Court without further review. See United States v. Reyna-
Tapia, 328 F.3d 1114, 1121 (9th Cir. 2003). Failure to file timely objections to any factual
determination of the Magistrate Judge may be considered a waiver of a party’s right to
appellate review of the findings of fact in an order or judgment entered pursuant to the
Magistrate Judge’s recommendation. See Fed. R. Civ. P. 72. In addition, LRCiv 7.2(e)(3)
provides that “[u]nless otherwise permitted by the Court, an objection to a Report and
Recommendation issued by a Magistrate Judge shall not exceed ten (10) pages.”
Dated this 26th day of June, 2026.
Case 2:26-cv-00675-SHD Document 16 Filed 06/26/26 Page 19 of 19