Ellsworth 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
Jennifer M Ellsworth,
Plaintiff,
v.
Commissioner of Social Security
Administration,
Defendant.
No. CV-25-00114-TUC-RM (MSA)
REPORT AND
RECOMMENDATION
Plaintiff Jennifer Ellsworth seeks judicial review of an unfavorable decision issued
by the Commissioner of Social Security Administration. For the following reasons, the
Court will recommend that the Commissioner’s decision be reversed and that this matter
be remanded for a new hearing and decision.
Background
Plaintiff is 51 years old. (See AR 317.) She has a college education. (AR 351.) She
worked for Comcast for 21 years as a technician and another 2 years as a supervisor.
(AR 358.) She stopped working in 2019 because of her conditions. (AR 180.)
In 2021, Plaintiff filed an application for disability insurance benefits, alleging that
she was disabled because of rheumatoid arthritis, osteoarthritis, fibromyalgia, spinal disc
degeneration and neuroforaminal stenosis, and depression. (AR 317, 350.) Her application
was denied initially and on reconsideration. (AR 201, 214.) She requested a hearing before
an administrative law judge (ALJ), and a hearing was held in late 2023. (AR 177, 240.)
After the hearing, the ALJ issued a written decision following the five-step process
Case 4:25-cv-00114-RM Document 22 Filed 12/08/25 Page 1 of 16

- 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
for determining whether a person is disabled. See 20 C.F.R. § 404.1520. At step one, the
ALJ found that Plaintiff had not engaged in substantial gainful activity since her alleged
onset date. (AR 41.) At step two, the ALJ found that Plaintiff had five severe impairments:
rheumatoid arthritis, osteoarthritis of the thumbs, fibromyalgia, degenerative disc disease,
and headaches. (AR 41.) At step three, the ALJ found that Plaintiff did not have an
impairment or a combination of impairments that met or medically equaled the severity of
a listed impairment. (AR 44.) Between steps three and four, the ALJ found that Plaintiff
had the residual functional capacity to perform sedentary work with certain exertional,
nonexertional, and environmental restrictions. (AR 45–46.) At step four, the ALJ found
that Plaintiff could not perform her past relevant work. (AR 50.) At step five, the ALJ
found that Plaintiff could adjust to other work that exists in sufficient numbers nationwide.
(AR 51.) The ALJ therefore concluded that Plaintiff was not disabled. (AR 52.)
The Appeals Council denied review, making the ALJ’s decision the final decision
of the Commissioner. (AR 1.) This proceeding followed. (Doc. 1.)
Legal Standard
The Commissioner’s decision will be affirmed if it is supported by substantial
evidence and free of legal error. Wischmann v. Kijakazi, 68 F.4th 498, 504 (9th Cir. 2023)
(citing Brewes v. Comm’r of Soc. Sec. Admin., 682 F.3d 1157, 1161–62 (9th Cir. 2012)).
“Substantial evidence means more than a mere scintilla, but less than a preponderance; it
is such relevant evidence as a reasonable person might accept as adequate to support a
conclusion.” Glanden v. Kijakazi, 86 F.4th 838, 843 (9th Cir. 2023) (quoting Lingenfelter
v. Astrue, 504 F.3d 1028, 1035 (9th Cir. 2007)).
Discussion
Plaintiff argues that the ALJ erred in discounting her symptom testimony and in
formulating her residual functional capacity. She asks that the ALJ’s decision be reversed
and that this case be remanded for an immediate award of benefits. As discussed below,
the Court agrees that the ALJ committed error that warrants reversal. The Court disagrees,
however, that Plaintiff is entitled to an immediate award of benefits.
Case 4:25-cv-00114-RM Document 22 Filed 12/08/25 Page 2 of 16

- 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
I. Symptom Testimony
At her hearing and in a function report, Plaintiff provided testimony about various
limitations arising from her impairments. (AR 184–93, 376–85.) The parties agree that the
ALJ could reject Plaintiff’s testimony only for “specific, clear and convincing reasons.”
Ferguson v. O’Malley, 95 F.4th 1194, 1199 (9th Cir. 2024) (quoting Garrison v. Colvin,
759 F.3d 995, 1014–15 (9th Cir. 2014)). This “standard requires an ALJ to show his work”
and is satisfied when “the ALJ’s rationale is clear enough that it has the power to convince.”
Smartt v. Kijakazi, 53 F.4th 489, 499 (9th Cir. 2022).
A. Manipulative Limitations
Plaintiff first takes issue with the ALJ’s treatment of her testimony about her hand
limitations. (Opening Br. 19.) She testified that her hands are “almost non-functioning”
and that she cannot perform fine motor tasks including opening jars, fastening buttons, and
tying. (AR 185, 193, 376.) She also testified that her hands swell, that she cannot lift even
a gallon of milk, and that she frequently drops things. (AR 193, 381.) The ALJ agreed that
Plaintiff has manipulative limitations, as he restricted her to frequent overhead reaching,
handling, and fingering and found that she should use braces as needed. (AR 46.) However,
for two reasons, the ALJ found that her symptoms were not as severe as alleged.
First, the ALJ found that Plaintiff’s testimony was not fully corroborated by, and
was inconsistent with, the objective medical evidence. (AR 47–49.) This is a proper ground
for discounting testimony. Smartt, 53 F.4th at 498. The ALJ acknowledged that Plaintiff’s
hand impairments were confirmed through imaging and objective findings. (AR 47 (noting
that “[t]here is medical documentation that the claimant was recommended on thumb base
splint for bilateral thumbs secondary to osteoarthritis,” and that “x-rays of bilateral hands
confirmed bilateral hand/wrist osteoarthritis.”).) The ALJ found, however, that Plaintiff’s
treatment was “routine . . . with no documented complications even with medication
adjustments.” (AR 47.)
This reasoning is supported by substantial evidence. The longitudinal record shows
that Plaintiff had decreased grip strength and frequent synovitis, but there is little to no
Case 4:25-cv-00114-RM Document 22 Filed 12/08/25 Page 3 of 16

- 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
evidence supporting her testimony that her hands are “almost non-functioning.” Notably,
as the ALJ observed, Plaintiff’s most recent treatment records indicate that her arthritis was
controlled by medication. (AR 47–48.) In June 2023, her treating rheumatologist noted that
her arthritis was “stable on methotrexate and Enbrel” with “[n]o major flareup.” (AR 1741.)
In September 2023, at the last appointment documented in the record, Plaintiff complained
that she was unable to do many activities because of thumb pain, and she had “very tender”
thumb joints on examination. (AR 1749–50.) Still, the rest of her hand joints were “without
significant synovitis and tenderness,” and she reported that methotrexate and Enbrel
provided “overall good control of [her] inflammatory arthritis symptoms.” (AR 1749–50.)
The ALJ could rationally interpret this evidence as showing that Plaintiff’s symptoms are
less severe than alleged, and that her limitations would be accommodated by braces and
reduced reaching, handling, and fingering.
Plaintiff argues that the ALJ misconstrued numerous treatment records supporting
her testimony. (Opening Br. 9–12, 23–25.)1 For instance, she says that the ALJ erred in
relying on notations that her arthritis was “stable,” because that term “simply means no
medication change,” not “the absence of pain, fatigue, or functional limitation.” (Id. at 10.)
She also says that the ALJ ignored evidence that supports her testimony, including that she
was “prescribed four different DMARDs from 2021 to 2022” and that a hand surgeon
found that she has “bone-on-bone” arthritis in her thumbs. (Id. at 11–12.) Finally, she says
that the ALJ erred by not considering that her testimony was consistent with her function
report and her partner’s function report. (Id. at 20.)
These arguments are not persuasive. As noted, Plaintiff’s most recent records
indicate that, over a several month period, medication provided “overall good control” of
her arthritis symptoms. In this context, the ALJ could rationally find that “stable” referred
to Plaintiff’s overall condition, not to changes in her medication. And to the extent that
Plaintiff highlights evidence that supports her testimony, that does not show that the ALJ’s
1 The Commissioner argues that Plaintiff waived any challenge to the ALJ’s analysis
of the objective medical evidence. (Answering Br. 8.) While the section of Plaintiff’s brief
that is devoted to her symptom testimony does not contain any analysis of the objective
evidence, other sections do. Thus, there was no waiver.
Case 4:25-cv-00114-RM Document 22 Filed 12/08/25 Page 4 of 16

- 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
findings were irrational. It bears mentioning again that the ALJ did not reject Plaintiff’s
testimony outright; the ALJ found that she has limitations that are less severe than alleged.
Given the records described above, this finding was rational. Finally, the Court agrees with
the Commissioner that the ALJ did not need to accept Plaintiff’s testimony merely because
it was consistent with her prior statements and her partner’s statements. (Answering Br. 9.)
The ALJ’s second reason for discounting Plaintiff’s testimony was that it was
inconsistent with her “acknowledged activities level.” (AR 49.) This is also a proper reason
for discounting symptom testimony. Smartt, 53 F.4th at 499. Here, however, the ALJ
provided a list of activities without explaining which activities undermine which testimony.
While the ALJ listed activities that could conceivably conflict with testimony about hand
limitations (e.g., “doing self-care/hygiene without assistance, doing simple chores, cooking
simple meals,” “cleaning and doing laundry, driving a car,” and “reading”), there is no
obvious inconsistency between those activities and Plaintiff’s specific reports. As to self-
care, Plaintiff needs help shaving because she cannot hold a razor, and she does not style
her hair except to put it in a ponytail; as to chores, her partner helps fold laundry, and her
son vacuums; as to cooking, she needs others to open cans and packages, and she preps
only what she can so that others can finish later; as to driving, she does not drive when she
has swelling, and she gets rides to appointments; and as to reading, she props up her
electronic reading device because she cannot hold a book. (AR 186, 378, 380–82.) Given
the lack of explanation as to how Plaintiff’s activities are inconsistent, substantial evidence
does not support the ALJ’s reasoning. See Ferguson, 95 F.4th at 1203 (“But, the ALJ did
not explain how, in his view, Ferguson’s testimony about those daily activities is
inconsistent with his testimony about the severity and frequency of his headaches. And we
see no reasonable inference that such an inconsistency exists.”).
Although the ALJ’s second reason is not supported by substantial evidence, the
Court finds that the objective medical evidence is a clear and convincing reason for
discounting Plaintiff’s testimony. Furthermore, even if it is not, any error in discounting
Plaintiff’s testimony about her hand limitations was harmless. The vocational expert
Case 4:25-cv-00114-RM Document 22 Filed 12/08/25 Page 5 of 16

- 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
testified that the surveillance system monitor job does not require any reaching, handling,
fingering, or feeling, and that there are 134,000 jobs available nationwide. (AR 198–200.)
So, even if Plaintiff’s manipulative limitations are greater than the ALJ found, Plaintiff
would still be able to adjust to other work and thus not be disabled. See Leach v. Kijakazi,
70 F.4th 1251, 1256 (9th Cir. 2023) (stating that an ALJ’s error is harmless when it “was
inconsequential to the ultimate nondisability determination” (citing Lambert v. Saul,
980 F.3d 1266, 1278 (9th Cir. 2020))).
B. Neck and Back Pain
Plaintiff next takes issue with the ALJ’s treatment of her testimony about neck and
back pain. (Opening Br. 19–20.) She testified that these conditions prevent her from sitting
for more than 30 minutes at a time and require her to lay down for 4 to 5 hours every day.
(AR 191–93.) She also testified that her neck pain causes headaches “several times a
week.” (AR 191–92.) The ALJ discounted Plaintiff’s testimony based on the objective
medical evidence and Plaintiff’s daily activities and concluded that her limitations would
be fully accommodated by a sedentary residual functional capacity. (AR 48–49.)
As to the objective medical evidence, the ALJ found that Plaintiff “received routine
treatment and pain management for neck/back pain” and that her “physical examinations
were mainly within normal limits.” (AR 48.) Substantial evidence supports this reasoning.
The ALJ offered examples of objective findings that were not consistent with the symptom
severity alleged by Plaintiff. For example, in March 2022, while Plaintiff had tenderness
in her neck and pain with facet loading, she had full range of motion in her cervical spine
and a negative Spurling’s test. (AR 48, 1695.) She also had a normal range of motion in
her cervical spine in September 2022. (AR 48, 1670.) Review of the record confirms that
these examples are representative of “mainly” normal physical examinations. (See AR 597
(supple neck in early February 2022); AR 1031 (tenderness in neck and pain with facet
loading, but full range of motion of cervical spine, in mid-February 2022); AR 573, 575
(decreased range of motion in neck, but no guarded movements of neck or back, in March
2022); AR 593 (tender cervical spine but no back pain in June 2022); AR 1095 (normal
Case 4:25-cv-00114-RM Document 22 Filed 12/08/25 Page 6 of 16

- 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
range of motion in neck in September 2022); AR 1066 (supple neck and no back pain in
October 2022); AR 1151 (supple neck and no back pain in April 2023); AR 1202 (normal
range of motion in neck in early May 2023); AR 1538 (supple neck in late May 2023);
AR 1196 (supple neck in July 2023). The ALJ could rationally find that this evidence was
inconsistent with the symptom severity alleged by Plaintiff. See Smartt, 53 F.4th at 498
(observing that the Ninth Circuit Court of Appeals has “affirm[ed] an ALJ’s rejection of
allegations of disabling pain based on normal physical examinations” (citing Osenbrock v.
Apfel, 240 F.3d 1157, 1165–66 (9th Cir. 2001))).
Plaintiff argues that the ALJ misconstrued the records that he cited as examples.
(Opening Br. 13–14.) For instance, she says that the ALJ erred in relying on the September
7, 2022 treatment record because that appointment did not include a musculoskeletal or
neurological exam. (Id. at 13–14.) But that record states that Plaintiff underwent a physical
examination, and that she had a “supple” neck with “normal range of motion.” (AR 1670.)
It was rational for the ALJ to accept this record at face value. Next, Plaintiff says the ALJ
ignored that, at the March 31, 2022 appointment, she had “pain on palpation of the right
cervical paraspinals” and “discrete muscle banding.” (Opening Br. 14.) But the ALJ
acknowledged that she had “pain with facet loading and tenderness to palpation.” (AR 48.)
The ALJ’s failure to note every positive finding, such as “discrete muscle banding,” does
not equate to a misrepresentation of that record. Plaintiff also says that the ALJ ignored
“MRI results showing cervical lordosis reversal, disc bulges, and lumbar foraminal stenosis
with nerve root impingement.” (Opening Br. 14.) This is incorrect: the ALJ began his
analysis by stating that Plaintiff’s spinal conditions were “confirmed on diagnostic imaging
studies” and citing the studies that Plaintiff says he ignored. (AR 48 (citing AR 1699–
1703).) Finally, Plaintiff argues that the ALJ erred in failing to recognize that her
conditions are “well known” to cause certain limitations. (Opening Br. 14, 19.) But as the
Commissioner states, the issue is not whether a condition is generally known to cause
certain limitations; it is whether Plaintiff’s condition causes her those limitations.
(Answering Br. 8–9.) As stated above, the ALJ rationally found based on Plaintiff’s
Case 4:25-cv-00114-RM Document 22 Filed 12/08/25 Page 7 of 16

- 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
examinations that her limitations are not as severe as alleged.
The ALJ also discounted Plaintiff’s testimony on the ground that it was inconsistent
with her daily activities. (AR 49.) As explained above, however, the ALJ listed Plaintiff’s
activities without explaining which activities undermine which testimony, and there is no
obvious inconsistency with Plaintiff’s specific reports (e.g., a person could perform the
listed activities when she does not have headaches and when she is not laying down). Thus,
substantial evidence does not support the ALJ’s reasoning. Even so, the Court finds that
the objective medical evidence is a clear and convincing reason for discounting Plaintiff’s
testimony that her neck and back pain precludes her from sitting for more than 30 minutes,
requires her to lay down for up to 5 hours every day, and causes several headaches a week.
C. Migraines
Plaintiff also challenges the ALJ’s analysis of her testimony that she gets migraines
that incapacitate her for the entire day. (Opening Br. 14–16, 19; AR 192.) The ALJ
discounted Plaintiff’s testimony on the ground that it was inconsistent with the objective
medical evidence and her daily activities. (AR 48–49.) As discussed above, the ALJ’s
analysis with respect to Plaintiff’s daily activities is not supported by substantial evidence.
There is no explanation as to why the activities are inconsistent; nor is there an obvious
inference of an inconsistency, as a person could perform the listed activities when she does
not have migraines.
As for the objective medical evidence, the ALJ found that Plaintiff “received only
routine medical treatment with relief of symptoms.” (AR 48.) This reasoning is not
supported by substantial evidence. The ALJ first cited a treatment record dated September
8, 2022, stating that the record showed Plaintiff’s “treatment decreased the intensity of the
migraine with aura.” (AR 48.) However, as Plaintiff points out, the treatment note did not
refer to migraine treatment provided that day; it was a reference to the fact that Plaintiff’s
migraines had decreased in intensity since childhood. (Opening Br. 15; AR 1671 (“Patient
had migraine with aura since childhood. They decreased intensity. PFO closure can help
it.”).) The ALJ then cited an emergency room visit in February 2023 for vertigo and acute
Case 4:25-cv-00114-RM Document 22 Filed 12/08/25 Page 8 of 16

- 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
migraine, stating that Plaintiff’s symptoms were relieved by meclizine and Zofran.
(AR 48.) Plaintiff correctly observes, however, that the cited record does not state that
those medications relieved her migraine symptoms, or even that her migraine symptoms
were relieved. (Opening Br. 15; see AR 1728 (stating that “the cause of [Plaintiff’s]
headache is unclear at this time”).) A few days after the emergency room visit, Plaintiff’s
rheumatologist remarked that the medications had been marginally helpful in relieving her
vertigo symptoms. (AR 1378 (“Her chief complaint is dizziness or vertigo . . . . [S]he was
given meclizine and Zofran which do help her symptoms but she remains nearly debilitated
with the symptoms.”).)
Next, the ALJ cited an April 3, 2023 statement by Plaintiff that she “ha[d] used
imitrex nasal spray with some relief of migraine symptoms in the past.” (AR 48, 1150.) It
is certainly proper for an ALJ to rely on evidence that a claimant’s symptoms are controlled
by medication, but Plaintiff’s report of “some relief . . . in the past” is hardly a clear and
convincing reason for discounting her testimony. The ALJ next cited a June 19, 2023
record, stating it “indicates that [Plaintiff’s] migraine with aura have decreased in intensity
and that ‘PFO closure can help’ migraine.” (AR 49.) The remark in question is identical to
the September 2022 remark referring to a decrease in intensity since childhood; it does not
refer to treatment provided that day or in the near past. (AR 1768 (“Patient had migraine
with aura since childhood. They decreased intensity. PFO closure can help it.”).) Finally,
the ALJ cited a July 3, 2023 report by Plaintiff that she was feeling better following her
PFO closure (heart surgery) and had had no headaches since then. (AR 49.) It is proper for
an ALJ to rely on reports of improved symptoms, but as Plaintiff observes, her report was
made only 14 days after the surgery. (Opening Br. 15–16; see AR 1765 (surgery record
dated June 19, 2023).) To be persuasive, the ALJ’s examples must show sustained
improvement. See Garrison, 759 F.3d at 1018 (“While ALJs obviously must rely on
examples to show why they do not believe that a claimant is credible, the data points they
choose must in fact constitute examples of a broader development to satisfy the applicable
‘clear and convincing’ standard.”).
Case 4:25-cv-00114-RM Document 22 Filed 12/08/25 Page 9 of 16

- 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
The ALJ did not discuss any other objective medical evidence. Thus, his finding
that Plaintiff’s migraines are less severe than alleged rests on Plaintiff’s reports that Imitrex
provided “some relief . . . in the past” and that she had had no headaches during the 14 days
following her surgery. As explained above, neither report holds significant weight. Thus,
the ALJ failed to provide clear and convincing reasons for rejecting Plaintiff’s testimony.
D. Foot Limitations
Finally, Plaintiff challenges the ALJ’s analysis of her testimony that she cannot walk
for extended periods due to foot pain and swelling. (Opening Br. 20; AR 186–87.) Plaintiff
says that the “ALJ’s decision entirely omits any discussion of [her foot] impairment or its
functional effects” and that the ALJ erred by not “explain[ing] why this limitation was
omitted” from her residual functional capacity. (Opening Br. 17, 20.) This argument is not
persuasive. The ALJ did discuss Plaintiff’s foot impairment. At step two, the ALJ analyzed
the objective medical evidence and found that the impairment was nonsevere. (AR 41–42.)
Specifically, the ALJ discussed records indicating that, notwithstanding Plaintiff’s foot
impairment, Plaintiff had normal gait and no focal deficits from February 2021 through
September 2023 (the end of the record). (AR 41–42.) Plaintiff forfeited any challenge to
this analysis by not addressing it in her briefing, and, moreover, the Court finds that the
ALJ’s conclusion is supported by substantial evidence. The ALJ did not err in rejecting
testimony about extreme limitations arising from a nonsevere impairment. See 20 C.F.R.
§ 404.1522(a) (“An impairment or combination of impairments is not severe if it does not
significantly limit your physical or mental ability to do basic work activities.”).
* * *
The ALJ failed to provide clear and convincing reasons for rejecting Plaintiff’s
testimony about migraines. If that testimony were accepted, then the ALJ would have to
account for the fact that Plaintiff would miss a day of work whenever she has a migraine.
The record is unclear as to how often that would occur and as to whether the frequency of
migraines would preclude employment, so the Court cannot say that the error was
inconsequential to the ultimate nondisability determination. As such, the error was harmful.
Case 4:25-cv-00114-RM Document 22 Filed 12/08/25 Page 10 of 16

- 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
II. Residual Functional Capacity
The ALJ found that Plaintiff had the residual functional capacity to perform
sedentary work with certain exertional, nonexertional, and environmental restrictions.
(AR 45–46.) Plaintiff argues that the ALJ erred several times in reaching this conclusion.
Each alleged error is addressed in turn.
A. Function-by-Function Assessment
Plaintiff first argues that the ALJ erred by not providing a function-by-function
assessment. (Opening Br. 9–17; Reply Br. 5–7.) The Court disagrees.
Social Security Ruling 96-8p, 1996 WL 374184 (July 2, 1996), explains how ALJs
should assess a claimant’s residual functional capacity.2 It provides that the residual
functional capacity “assessment must first identify the [claimant’s] functional limitations
or restrictions and assess his or her work-related abilities on a function-by-function basis,
including the functions in paragraphs (b), (c), and (d) of 20 CFR 404.1545 and 416.945.”
Id. at *1. These functions include physical abilities such as sitting, standing, walking,
lifting, and carrying; mental abilities such as understanding, remembering, and carrying
out instructions; and other abilities that may be affected by impairments, such as the ability
to see, hear, or tolerate environmental factors. 20 C.F.R. § 404.1545(b)–(d). Only after this
assessment should the ALJ classify the claimant’s residual functional capacity in terms of
exertional levels of work (i.e., sedentary, light, medium, heavy, or very heavy). SSR 96-8p,
1996 WL 374184, at *1.
Here, the ALJ provided a function-by-function assessment. The ALJ found that
Plaintiff could lift and carry 10 pounds occasionally (i.e., very little up to one-third of the
time) and less than 10 pounds frequently (i.e., one-third up to two-thirds of the time); do
unlimited standing and walking; sit approximately 6 hours in an 8-hour day; frequently
climb ramps and stairs; occasionally climb ladders, ropes, and scaffolds; frequently balance
and stoop; occasionally kneel; frequently crouch; occasionally crawl; frequently reach
2 Social Security Rulings are not binding on federal courts, but courts defer to them
“as long as they are consistent with the Social Security Act and regulations.” Diedrich v.
Berryhill, 874 F.3d 634, 638 (9th Cir. 2017) (quoting Molina v. Astrue, 674 F.3d 1104,
1113 n.5 (9th Cir. 2012)).
Case 4:25-cv-00114-RM Document 22 Filed 12/08/25 Page 11 of 16

- 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
overhead bilaterally; frequently handle and finger; and have occasional exposure to cold,
wetness, vibration, and workplace hazards. (AR 45–46.) The ALJ supported these findings
with an analysis of the objective medical evidence, first addressing Plaintiff’s rheumatoid
arthritis, osteoarthritis of the thumbs, and fibromyalgia (AR 47–48), then addressing her
degenerative disc disease (AR 48), and then finally addressing her headaches and migraines
(AR 48–49).
As such, the ALJ complied with SSR 96-8p’s narrative requirement. Plaintiff argues
that the ALJ either ignored or misrepresented evidence that was favorable to her. (Opening
Br. 9–17.) Plaintiff’s analysis of the evidence is addressed in the preceding section; for the
reasons stated there, the Court largely disagrees with her criticisms of the ALJ’s analysis.
Plaintiff further argues that the ALJ was required to describe the functional impact of each
impairment individually. (Reply Br. 6.) However, the ALJ was required to do a function-
by-function assessment, not an impairment-by-impairment assessment. Therefore, it was
not error for the ALJ to group impairments that could cause related functional limitations.
B. Consideration of Nonsevere Impairments
Plaintiff asserts that the ALJ erred in failing to consider three of her nonsevere
impairments—her foot impairment, carpal tunnel syndrome, and history of strokes—in
formulating the residual functional capacity. (Opening Br. 17–18; Reply Br. 7–8.) The ALJ
specifically addressed each of these impairments at step two, though he did not assign the
significance to them that Plaintiff prefers. (AR 41–42.) As previously explained, the ALJ
found that Plaintiff’s foot impairment was nonsevere and that she could do unlimited
standing and walking. (AR 41–42, 45.) Substantial evidence supports that conclusion.
Likewise, the ALJ found that while imaging “showed findings consistent with right
carpal tunnel syndrome,” that condition was nonsevere because Plaintiff “received no
ongoing treatment from a neurologist.” (AR 42.) Notably, Plaintiff says that her symptoms
from this condition “overlap with and exacerbate” those caused by her arthritis. (Opening
Br. 18.) As previously explained, the ALJ’s conclusion about Plaintiff’s hand limitations
is supported by substantial evidence.
Case 4:25-cv-00114-RM Document 22 Filed 12/08/25 Page 12 of 16

- 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
Finally, the ALJ found that Plaintiff’s history of strokes was nonsevere. (AR 42.)
Plaintiff asserts that her symptoms from this condition include “[c]hronic headaches,
dizziness, and vertigo, decreased coordination and postural instability, and cognitive
slowing and reduced concentration.” (Opening Br. 18.) As an initial matter, Plaintiff did
not report dizziness and vertigo in her function report or at the administrative hearing, and
the record reflects only transient dizziness in early 2023. (See AR 1558, 1724.) Nor did she
report decreased coordination or postural instability to the agency. As such, the ALJ cannot
be faulted for not addressing those alleged symptoms. Further, as explained in a preceding
section, the ALJ’s analysis of Plaintiff’s headaches is supported by substantial evidence.
As to Plaintiff’s ability to concentrate, the ALJ found that Plaintiff had no limitation based
on her testimony that she drives, prepares meals, watches television, reads, and manages
funds. (AR 43.) Plaintiff does not engage with that analysis, and the Court agrees that the
listed activities undermine her testimony about difficulty concentrating.
C. Adoption of Sedentary Residual Functional Capacity
Plaintiff argues that the ALJ erred in adopting a residual functional capacity that
“was less restrictive than both the consultative examiner’s opinion and the state agency
medical consultants’ opinions, without providing a clear rationale for this departure.”
(Opening Br. 22.) She says that while the ALJ claimed to adopt the opinions of the state-
agency physicians, he “omitted key limitations from that assessment in the final [residual
functional capacity].” (Id.) This argument is factually inaccurate, as the residual functional
capacity is nearly identical to the opinions of the agency physicians at both the initial and
reconsideration levels. (Compare AR 45–46 (ALJ decision), with AR 208–10 (initial
level), and AR 221–22 (reconsideration level).) As the Commissioner points out, there is
only one immaterial difference. (Answering Br. 11–12.) The agency physicians opined that
Plaintiff could stand or walk “more than 6 hours” in an 8-hour day (AR 221), and the ALJ
found that Plaintiff could “do unlimited standing/walking” (AR 45). In terms of functional
ability, the first level of limitation below “unlimited” is “frequent,” which equates to “a
total of approximately 6 hours in an 8-hour workday.” SSR 83-10, 1983 WL 31251, at *6
Case 4:25-cv-00114-RM Document 22 Filed 12/08/25 Page 13 of 16

- 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
(Jan. 1, 1983). The agency physicians found that Plaintiff could do more than 6 hours,
which is functionally the same as “unlimited.”
Plaintiff next argues that the ALJ could not rely on the agency physicians because
their opinions were “based solely on a partial and incomplete record.” (Opening Br. 22;
see Reply Br. 11–12.) She says that the most important records from her rheumatologist
were made later, and that the ALJ erred in failing to “acknowledge this gap or re-contact
any medical source for a new opinion based on the full record.” (Opening Br. 22–23.) The
Commissioner says that this argument reflects a misunderstanding of the law, and the Court
agrees. (Answering Br. 12.) The ALJ must articulate the persuasiveness of each medical
opinion based on factors including “supportability” and “consistency.” 20 C.F.R.
§ 404.1520c(b)(2). Supportability refers to the relevant “objective medical evidence and
supporting explanations presented” in support of the opinion. Id. § 404.1520c(c)(1).
Consistency refers to the consistency of the opinion “with the evidence from other medical
sources and nonmedical sources in the claim.” Id. § 404.1520c(c)(2). Under these factors,
an opinion is not defective merely because it was rendered without the benefit of the whole
record. An ALJ may accept such an opinion if it is supported by relevant evidence and
explanation and consistent with other evidence, including later treatment records.
That is the case here. The ALJ examined evidence dating from late 2020 to
September 2023 and found that the record as a whole supported the existence of functional
limitations—just not ones as restrictive as Plaintiff alleged. (AR 47–49.) That analysis
included discussion of records relied upon by the agency physicians. (See AR 47–48 (citing
records from July 2021, November 2021, March 2022, and June 2022); AR 222–23 (citing
the same records).) Given the foregoing, it is reasonable to infer that the ALJ found that
the agency physicians’ opinions were supported by the records available when the opinions
were rendered (July 2022 at the initial level and December 2022 at the reconsideration
level). See Magallanes v. Bowen, 881 F.2d 747, 755 (9th Cir. 1989) (explaining that a
reviewing court may draw logical inferences about an ALJ’s reasoning). And the ALJ
explicitly stated that the agency physicians’ opinions were “similar to the opinion of [the
Case 4:25-cv-00114-RM Document 22 Filed 12/08/25 Page 14 of 16

- 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
consulting physician] and [were] consistent with the treatment record and imaging
findings.” (AR 50.) Therefore, the ALJ’s evaluation of the opinion evidence was consistent
with the regulation and is supported by substantial evidence.
Plaintiff argues next that a sedentary residual functional capacity is inappropriate
because of her hand limitations. (Opening Br. 23–25.) She says that her “rheumatologist
repeatedly documented bilateral hand and thumb osteoarthritis, with persistent swelling,
tenderness, and reduced range of motion.” (Id. at 24.) She says the ALJ failed to account
for these findings and also ignored that she wears braces that “restrict both gross and fine
manipulation.” (Id.) She says that these errors warrant reversal because “the ability to
perform fine manipulation with both hands is critical to most unskilled sedentary work,”
and significant manipulative limitations “will result in a significant erosion of the unskilled
sedentary occupational base.” (Id.)
Plaintiff’s argument is not persuasive, for two reasons. First, substantial evidence
supports the ALJ’s finding that Plaintiff has manipulative limitations that are less severe
than alleged. Second, the ALJ found that Plaintiff could perform work as a surveillance
system monitor—a job that does not require any manipulative abilities. (AR 199–200.) So,
there is at least one job available in sufficient numbers that Plaintiff could perform
regardless of her manipulative abilities. Any error was therefore harmless.
III. Remedy
The ALJ committed harmful error in rejecting Plaintiff’s symptom testimony.
Plaintiff requests that the Court apply the credit-as-true rule and remand this case to the
agency for an immediate award of benefits. (Opening Br. 25–26; Reply 12–13.) The
Commissioner disagrees that remand is appropriate but says that, if the Court finds error,
remand should be for further proceedings and not an award of benefits. (Answering Br. 13.)
The Court agrees with the Commissioner.
Under the credit-as-true rule, the court must first “ask whether the ‘ALJ has failed
to provide legally sufficient reasons for rejecting evidence, whether claimant testimony or
medical opinion.’” Washington v. Kijakazi, 72 F.4th 1029, 1041 (9th Cir. 2023) (quoting
Case 4:25-cv-00114-RM Document 22 Filed 12/08/25 Page 15 of 16

- 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
Treichler v. Comm’r of Soc. Sec. Admin., 775 F.3d 1090, 1100–01 (9th Cir. 2014)). Here,
the ALJ erred in rejecting Plaintiff’s testimony about migraines. The court next must ask
“whether the record has been fully developed, whether there are outstanding issues that
must be resolved before a determination of disability can be made, and whether further
administrative proceedings would be useful.” Id. (quoting Treichler, 775 F.3d at 1101).
Here, the record needs further development as to the nature and frequency of Plaintiff’s
migraines. The ALJ seemed to believe that Plaintiff’s PFO closure significantly lessened
her migraines. (AR 49.) As Plaintiff’s date last insured is in December 2027, the ALJ would
be able to obtain additional evidence to make that determination.3 Further proceedings
would also be useful so that a vocational expert could testify as to whether Plaintiff’s
migraine-related limitations would preclude employment, which is not clear on the present
record. Thus, remand for an immediate award of benefits is not warranted.
Conclusion
The Court recommends that the Commissioner’s decision be reversed and that this
matter be remanded for a new hearing and decision.
This recommendation is not immediately appealable to the United States Court of
Appeals for the Ninth Circuit. The parties have 14 days to file specific written objections
with the district court. Fed. R. Civ. P. 72(b)(2). The parties have 14 days to file responses
to objections. Id. The parties may not file replies on objections absent the district court’s
permission. A failure to file timely objections may result in the waiver of de novo review.
United States v. Reyna-Tapia, 328 F.3d 1114, 1121 (9th Cir. 2003) (en banc). The Clerk of
Court is directed to terminate the referral of this matter. Filed objections should bear the
following case number: CV-25-00114-TUC-RM.
Dated this 8th day of December, 2025.
3 The ALJ would also be free to reconsider Plaintiff’s other impairments based on
any new evidence.
Case 4:25-cv-00114-RM Document 22 Filed 12/08/25 Page 16 of 16