Huff v. Commissioner of Social Security Administration

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IN THE UNITED STATES DISTRICT COURT
FOR THE DISTRICT OF ARIZONA
Brandy Huff,
Plaintiff,
v.
Commissioner of Social Security
Administration,
Defendant.
No. CV-25-00198-TUC-JGZ (JEM)
REPORT AND RECOMMENDATION
Plaintiff Brandy Huff (“Huff”) seeks judicial review of a final decision by the
Commissioner of the Social Security Administration (“Commissioner”). (Doc. 1.) The
matter, on referral to the undersigned United States Magistrate Judge for Report and
Recommendation, is ripe for determination. (Doc. 12, 14, 18, 19.) As more fully set forth
below, the undersigned recommends that the district court affirm the ALJ’s decision.
BACKGROUND
Procedural History
On October 12, 2021, Huff protectively filed a Title II application for a period of
disability and disability insurance benefits under the Social Security Act alleging disability
beginning June 7, 2020. (AR 16.) Huff’s application was denied initially on November 3,
2022, and on reconsideration on April 28, 2023. (AR 80-92 (disability determination at the
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initial level); AR 93-103 (disability determination at the reconsideration level).) On
February 5, 2024, Huff appeared and testified at a telephonic administrative hearing before
Administrative Law Judge (“ALJ”) Peter Baum. (AR 56-79.) On April 4, 2024, the ALJ
issued his non-disability decision. (AR 16-29.) On April 8, 2025, the Appeals Counsel
denied Huff’s request for review. (AR 1-6.)
The ALJ’s decision is the final decision of the Commissioner and the district court
has jurisdiction pursuant to 42 U.S.C. §§ 405(g) and 1383(c)(3).
The ALJ’s Decision
The ALJ found that Huff has not engaged in substantial gainful activity since June
7, 2020, her alleged onset date. (AR 18.) The ALJ determined that Huff suffers from the
severe medically determinable impairments of cognitive dysfunction, obesity, cervical
fusion, lumbar degenerative joint disease, psoriatic arthritis, generalized anxiety disorder,
major depressive disorder, and status post-bilateral foot surgery. (AR 19.) The ALJ
determined Huff does not have an impairment or a combination of impairments that meets
or medically equals the severity of one of the listed impairments in 20 CFR Part 404,
Subpart P, Appendix 1. (AR 20.) The ALJ determined Huff’s residual functional capacity
(“RFC”) as the ability:
to perform light work as defined in 20 CFR § 404.1567(b) except she can lift
and/or carry 20 pounds occasionally and 10 pounds frequently; stand and/or
walk six hours out of an eight-hour workday and sit six hours in an eight-
hour day. She is able to occasionally climb ramps and stairs, but never climb
ladders, ropes, or scaffolds. She can frequently balance and kneel,
occasionally stoop, crouch, and crawl. She can occasionally reach overhead
with the bilateral upper extremities. She can occasionally feel with the left
upper extremity. She should avoid moderate exposure to hazardous
machinery or unprotected heights. She is limited to simple, repetitive tasks
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and can have necessary, occasional contact with the public, customers,
coworkers, and supervisors.
(AR 21-22.) The ALJ determined that she is unable to perform her past relevant work. (AR
27.) Considering Huff’s age, education, work experience and RFC, the ALJ found that she
can make a successful adjustment to other work that exists in significant numbers in the
national economy. (AR 28.) Accordingly, the ALJ found that Huff has not been under a
disability from her alleged onset date through the date of the ALJ’s decision. (AR 29.)
Factual Background1
Huff was 47 years old years old as of June 7, 2020, her alleged onset date. She has
a high school education. (AR 241.) The ALJ found Huff’s past relevant work as a customer
service manager and composite EMT/firefighter/stock clerk to be skilled, medium to very
heavy. (AR 27.) She alleges disability based on psoriatic arthritis, degenerative joint
disease of the lumbar spine, status post cervical spinal fusion, status post bilateral foot
surgeries, cognitive disfunction, major depressive disorder, and generalized anxiety
disorder. (Doc. 14 at p. 3.)
Huff received a cervical epidural steroid injection in February 2020, lumbar epidural
steroid injections in March and July 2020, lumbar medial branch blocks in December 2020,
a lumbar radiofrequency ablation in January 2021, steroid injections in March and May
2021, another lumbar medial branch block in June 2021, and a sacroiliac joint
radiofrequency ablation in July 2021. (AR 430, Patient Chart Report dated June 7, 2019
through March 29, 2022.)
1 The factual background is taken primarily from Huff’s opening brief to which no
objection was made. Additional relevant facts are included in this Court’s analysis.
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In February 2021, after reviewing a lumbar MRI, neurosurgeon Joseph A.
Christiano, M.D., recommended that she continue with pain management opining that
“operative intervention would likely require an instrument lumbar fusion.” (AR 402.) A
July 2021 radiofrequency ablation was effective for approximately four months. (AR 432.)
On September 23, 2021, Dr. Christiano recorded that while Huff had received
lumbar spinal injections, her pain management provider had been unable to assist with neck
pain because of “tight stenosis at C5-C6.” (AR 399.) An anterior cervical diskectomy and
fusion at C4-5 and C5-6 were planned for December 12, 2021, with C3-4 and C6-7
excluded from fusion at that time. (AR 395.) Sacroiliac joint injections Huff received on
February 18, 2022 were ineffective. (AR 435.)
At a March 8, 2022, visit with Amy Jo Miltenberger, PA, PAC, Huff’s headaches
are recorded as being resolved, her arm and hand numbness improved, and physical therapy
was starting to be effective for her left shoulder soreness. (AR 658-660.) On March 11,
2022, Nicholas J. Elkins, D.O., Huff’s pain management provider, opined that a large
component of Huff’s pain was central sensitization or fibromyalgia. (AR 435-436.) On
April 19, 2022, Huff is recorded as still experiencing neck pinching and stiffness, that her
hand numbness has resolved, and that her headaches have nearly resolved. (AR 654-657.)
On October 28, 2022, Huff complained of hip and thigh pain to Dr. Elkins and he opined
that her complaints were “suggestive of left-sided greater trochanteric bursitis and likely
IT band syndrome.” (AR 909.)
On March 6, 2023, Farrell Roseberry, D.O., Huff’s primary care provider, ordered
a complete rheumatological workup. (AR 1030-1035.) Dr. Roseberry recorded that Huff’s
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neck had “significant reduced range of motion with tenderness to palpation,” her gait was
antalgic, and her hips, knees, and shoulders were tender. (AR 1033.) Antinuclear antibody
(“ANA”) testing was “ABN” positive but other rheumatological tests were negative. (AR
1027-1029.)
On April 6, 2023, Huff visited rheumatologist Brittany Panico, D.O. (AR 950-951.)
Huff is recorded as explaining that epidural steroid injections would relieve her back pain
for about a month. (AR 950.) She endorsed pain in hands, elbows, big toe joints, the
outsides of her feet, neck, sacroiliac joint, and gastrointestinal system and right knee
tenderness. Id. She also endorsed increased fatigue and difficulty completing household
chores. Id. Dr. Panico ordered podiatrist records to review x-rays of Huff’s sacroiliac joints
and feet, and prescribed Sulfasalazine. (AR 951.)
On June 19, 2023, Huff was diagnosed with psoriatic arthritis and Dr. Panico
prescribed Otezla. (AR 947-949.) On November 19, 2023, Dr. Panico recorded that Huff
could not tolerate Otezla and prescribed Huff Enbrel. (AR 941, 944.) After receiving
Enbrel injections, Huff is recorded as “not noticing that Enbrel has made a difference in
her pain so far. She is having more neck pain[;] this was relieved with steroid injections in
the past.” (AR 941.) On December 13, 2023, Dr. Panico recorded that Huff’s “joint pain
continues to be bothersome.” (AR 938.)
ISSUES ON REVIEW
Huff raises two issues for review. (Doc. 14 at p. 2.) First, Huff argues that the ALJ
failed to articulate clear and convincing reasons for discounting her symptom testimony.
Id. Second, she argues the ALJ failed to adequately articulate the supportability and
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consistency of two medical opinions. Id. The Commissioner argues against Huff’s claims
of error. (Doc. 18.) As more fully explained below, this Court agrees with the
Commissioner.
FIVE-STEP SEQUENTIAL EVALUATION PROCESS
The Commissioner employs a five-step sequential process to evaluate claims. 20
C.F.R. § 404.1520; see also Heckler v. Campbell, 461 U.S. 458, 460-462 (1983). To
establish disability the claimant bears the burden of showing: (1) s/he is not working;
(2) s/he has a severe physical or mental impairment; (3) the impairment meets or equals
the requirements of a listed impairment; and (4) the RFC precludes the performance of past
work. 20 C.F.R. § 404.1520(a)(4). At step five, the burden shifts to the Commissioner to
show that the claimant has the RFC to perform other work that exists in substantial numbers
in the national economy. Hoopai v. Astrue, 499 F.3d 1071, 1074 (9th Cir. 2007). If the
Commissioner conclusively finds the claimant “disabled” or “not disabled” at any point in
the five-step process, the ALJ does not proceed to the next step. 20 C.F.R.
§ 404.1520(a)(4).
“The ALJ is responsible for determining credibility, resolving conflicts in medical
testimony, and for resolving ambiguities.” Andrews v. Shalala, 53 F.3d 1035, 1039 (9th
Cir. 1995) (citing Magallanes v. Bowen, 881 F.2d 747, 750 (9th Cir. 1989)). The findings
of the Commissioner are meant to be conclusive if supported by substantial evidence. 42
U.S.C. § 405(g). Substantial evidence is “more than a mere scintilla but less than a
preponderance.” Tackett v. Apfel, 180 F.3d 1094, 1098 (9th Cir. 1999) (quoting Matney v.
Sullivan, 981 F.2d 1016, 1018 (9th Cir. 1992)). The court may overturn the decision to
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deny benefits only “when the ALJ’s findings are based on legal error or are not supported
by substantial evidence in the record as a whole.” Aukland v. Massanari, 257 F.3d 1033,
1035 (9th Cir. 2001). This is so because the ALJ “and not the reviewing court must resolve
conflicts in the evidence, and if the evidence can support either outcome, the court may not
substitute its judgment for that of the ALJ.” Matney, 981 F.2d at 1019 (quoting Richardson
v. Perales, 402 U.S. 389, 400 (1971)); Batson v. Comm’r of Soc. Sec. Admin., 359 F.3d
1190, 1198 (9th Cir. 2004). The Commissioner’s decision, however, “cannot be affirmed
simply by isolating a specific quantum of supporting evidence.” Sousa v. Callahan, 143
F.3d 1240, 1243 (9th Cir. 1998) (citing Hammock v. Bowen, 879 F.2d 498, 501 (9th Cir.
1989)). Reviewing courts must consider the evidence that supports as well as detracts from
the Commissioner’s conclusion. Day v. Weinberger, 522 F.2d 1154, 1156 (9th Cir. 1975).
A claimant is "disabled" for the purpose of receiving benefits if she is unable to
engage in any substantial gainful activity due to an impairment which has lasted, or is
expected to last, for a continuous period of at least twelve months. 42 U.S.C. §
423(d)(1)(A); 20 C.F.R. § 404.1505(a). "The claimant bears the burden of establishing a
prima facie case of disability." Roberts v. Shalala, 66 F.3d 179, 182 (9th Cir. 1995), cert.
denied, 517 U.S. 1122 (1996); Smolen v. Chater, 80 F.3d 1273, 1289 (9th Cir. 1996).
ANALYSIS
The ALJ Did Not Err in His Credibility Analysis
The ALJ gave four reasons for discounting Huff’s symptom testimony. First, the
ALJ found certain of Huff’s complaints to be exaggerated. (AR 22.) Second, the ALJ found
that Huff improved with treatment. (AR 22-23.) Third, the ALJ found Huff’s symptom
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testimony to be inconsistent with her activities of daily living. (AR 25.) Fourth, the ALJ
found Huff’s symptom testimony to be inconsistent with the objective medical evidence.
(AR 22.) Huff argues that the ALJ’s reasons fail to meet the specific, clear and convincing
standard required to reduce her credibility regarding her symptom testimony. (Doc. 14 at
pp. 10-16.) The Commissioner defends the ALJ’s reduced credibility determination. (Doc.
18 at pp. 3-10.) As explained below, this Court finds that the ALJ’s reasons for discounting
Huff’s symptom testimony are specific, clear and convincing reasons supported by
substantive evidence.
Reduced Credibility Standard
Disability benefits cannot be granted based solely on a claimant’s subjective
complaints. See 42 U.S.C. § 423(d)(5)(A) (stating, inter alia,“[a]n individual’s statement
as to pain or other symptoms shall not alone be conclusive evidence of disability”); 20
C.F.R. § 404.1529(a) (statements about pain or other symptoms will not alone establish
disability). Where a claimant has provided objective medical evidence of an impairment
that could reasonably produce the alleged symptoms, the ALJ evaluates the intensity and
persistence of the symptoms. See SSR 16-3p, 2016 WL 1119029 (Mar. 16, 2016). The ALJ
is required to evaluate whether a claimant’s statements about her symptoms are consistent
with the objective medical evidence and the other evidence in the record. See 20 C.F.R. §
404.1529(c)(2), (3); SSR 16-3p, 2016 WL 1119029. The ALJ must make specific findings
about a claimant’s allegations, properly supported by the record and sufficiently specific
to ensure a reviewing court that the claimant’s subjective testimony was not arbitrarily
discredited. See Thomas v. Barnhart, 278 F.3d 947, 958 (9th Cir. 2002) (citing Bunnell v.
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Sullivan, 947 F.2d 341, 345-46 (9th Cir. 1991) (en banc)). Unless there is affirmative
evidence that a claimant is malingering, an ALJ’s reasons for discounting the claimant’s
testimony regarding the severity of his symptoms must be “clear and convincing.” Reddick
v. Chater, 157 F.3d 715, 722 (9th Cir. 1998). “If the ALJ's . . . finding is supported by
substantial evidence, [a court] may not engage in second-guessing.” Kelly L. K. v. Saul,
No. 5:20-cv-1773-MAR, 2021 WL 3269981, at *6 (C.D. Cal. July 30, 2021) (citing
Thomas, 278 F.3d at 959)).
Analysis
Activities of Daily Living/Admitted Hobbies
The ALJ is permitted to consider evidence of a claimant’s daily activities in reaching
a credibility determination. 20 C.F.R. § 404.1529(c)(3); Smartt v. Kijakazi, 53 F.4th 489,
499 (9th Cir. 2022) (recognizing that “[a]n ALJ may also consider whether the claimant
engages in daily activities inconsistent with the alleged symptoms.”). In the Ninth Circuit,
“[w]ith respect to daily activities . . . if a claimant ‘is able to spend a substantial part of
[her] day engaged in pursuits involving the performance of physical functions that are
transferable to a work setting, a specific finding as to this fact may be sufficient to discredit
a claimant's allegations.’” Vertigan v. Halter, 260 F.3d 1044, 1049 (9th Cir. 2001) (quoting
Morgan v. Comm’r of Soc. Sec. Admin., 169 F.3d 595, 599 (9th Cir. 1999)). “Even where
[a claimant’s] activities suggest some difficulty functioning, they may be grounds for
discrediting the claimant’s testimony to the extent that they contradict claims of a totally
debilitating impairment.” Molina v. Astrue, 674 F.3d 1104, 1113 (9th Cir. 2012).
Huff complains that she cannot bend over, can stand for only five to ten minutes,
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and can sit for fifteen minutes before she must lay down. In reducing Huff’s credibility,
the ALJ found:
Greater limitation is not warranted as [Huff] reported intact activities of daily
living, including in June 2022, she reported taking a trip to Hawai’i for
vacation and gardening more (6F/3, 7). In August 2022, she reported driving
her daughter to Phoenix and stated her hobbies included going on cruises
with her husband (7F/3).
(AR 25.) Huff argues the ALJ did not specify how her activities of daily living are
inconsistent with her claims of debilitating symptoms (Doc. 14 at pp. 15-16.) This Court
disagrees, finding that the ALJ’s reasoning can be reasonably discerned. See Molina v. 674
F.3d at 1121 (recognizing that “[e]ven when an agency “explains its decision with ‘less
than ideal clarity,’” we must uphold it “if the agency's path may reasonably be discerned.”).
Huff testified that she can only sit for fifteen minutes. (AR 70.) However, as pointed
out by the ALJ, there is evidence that she can sit to prepare meals and drive long distances.
See AR 70 (Huff’s testimony that she can sit in her recliner and “assemble” a casserole and
chop vegetables); AR 773 (Huff reported at a consultative examination that “she is driving
her daughter to Phoenix today”).
Huff also admits to gardening more but argues that “she [i]s not exerting [herself]
while doing so” and that she “ask[ed] for additional pain medications.” (Doc. 14 at p. 16.)
This Court is not persuaded by Huff’s argument that the ALJ is not permitted to consider
her admitted increase in gardening in reaching a credibility determination because she is
not exerting herself while gardening. Huff has admitted to spending more of her day
gardening. That she asked for more pain medication supports an inference that additional
pain medication successfully allows Huff to perform increased, although non-exertional,
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gardening. The RFC limits Huff to light work with additional exertional limitations which
is consistent with Huff’s endorsement of spending more of her time engaged in non-
exertional gardening.
Huff also complains that the ALJ improperly relied upon her travel to Hawai’i in
reducing her credibility. (Doc. 14 at p. 15.) Huff urges that “[i]t is very possible to spend a
Hawai’ian vacation or a cruise mostly lounging. Id. at pp. 15-16. While that may be the
case, the ALJ did not err in considering Huff’s admitted hobby of “going on cruises with
her husband” in evaluating her complaints of debilitating pain. See Tommasetti v. Astrue,
533 F.3d 1035, 1039 (9th Cir. 2008) (ALJ may consider, inter alia, claimant’s daily
activities in weighing a claimant’s credibility).
Improvement with Treatment
An ALJ is permitted to consider a claimant’s improvement with treatment in
reaching a credibility determination. See 20 C.F.R. § 404.1529(c)(3)(iv)-(v); Wellington v.
Berryhill, 878 F.3d 867, 876 (9th Cir. 2017) (improvement with treatment can undermine
a disability claim).
Here, the ALJ found that Huff’s symptom testimony was contrary to evidence in the
record documenting symptom improvement following treatment and medication. The ALJ
pointed to records showing that Huff’s elbow pain resolved and her radicular pain, shoulder
discomfort, headaches, and hand numbness improved following neck surgery. (AR 23, 25,
citing AR 383 (February 8, 2022, medical record recording that as of January 24, 2022,
“[s]he no longer has elbow pain, and the radicular pain has decreased. There is still some
left shoulder discomfort and hand numbness remaining, but it has improved.”; AR 386
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(post-operative visit record documenting reports of reduced elbow pain, reduced radicular
paid and improved left shoulder discomfort and hand numbness); AR 570 (record
documenting that as of March 8, 2022, “[t]he arm pain and hand numbness have improved.
She has left shoulder soreness, for which PT is just beginning to work on. . . . headaches
have improved.. . . Headaches have nearly resolved.”); AR 581 (April 20, 2022, record
noting that Huff “says she is in much less pain than she had been . . . Her neck is much
better than it had been.”)
The ALJ also pointed to evidence in the record documenting that Huff’s lower back
symptoms improved following medication and treatment. (AR 23, 25, citing AR 871
(March 17, 2023, record from Mark E. Cameron, ACNPC-AG, recording 50% relief of low
back symptoms following radiofrequency ablation); AR 891-92 (January 12, 2023, record
from Samuel C. Crandell, PA-C, recording improvement in back and hip symptoms).
Regarding mental impairments, the ALJ noted that Huff reported improved symptoms with
medication. (AR 24, citing AR 992 (September 18, 2023, record stating, “The patient did
note that the escitalopram is working well and we did refill that medication for the patient
today.”); AR 1032 (March 6, 2023, record noting Huff reported “Lexapro has been working
well for her depression.”)
Huff agrees that improvement with treatment is a relevant factor that an ALJ may
consider in reaching a credibility determination. (Doc. 14 at p. 14.) However, she argues
that her symptom improvement should not be considered because it was only temporary.
Id. She summarily argues, “[t]he ALJ has not cited a clear and convincing reason to find
symptoms less severe than alleged where improvement with injections was temporary and
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did not last the length of time between treatments.”). (Doc. 14 at p. 15.)
Contrary to Huff’s assertion, the ALJ pointed to evidence documenting that Huff
obtained relief from certain symptoms following medication and treatment, such as surgery
and physical therapy, while also acknowledging that Huff’s treatment did not entirely
resolve her conditions and that relief was sometimes temporary. See e.g., AR 23 (ALJ’s
decision recognizing that “claimant was treated with steroid injections and reports some
improvement.”) The ALJ did not find that Huff was symptom free and the RFC
appropriately includes exertional limitations. This Court finds that the ALJ considered the
entirety of the record, including Huff’s improvement and her ongoing treatment for her
reported pain, and that the ALJ’s reliance on improvement with treatment is a specific,
clear and convincing reason supporting the ALJ’s reduced credibility determination.
Symptom Exaggeration
“The ALJ may consider many factors in weighing a claimant's credibility, including
ordinary techniques of credibility evaluation, such as the claimant's reputation for lying,
prior inconsistent statements concerning the symptoms, and other testimony by the
claimant that appears less than candid.” Tommasetti, 533 F.3d at 1039 (internal quotations
omitted). Huff argues the ALJ’s finding that she exaggerated her symptoms is
“inconsequential” and that “the symptoms the ALJ addressed . . . are not [her] primary-
disability symptoms.” (Doc. 14 at pp. 13-14.)
The ALJ pointed to instances where Huff exaggerated her symptoms and was not
an accurate historian regarding her medical history. (For example, the ALJ pointed to
Huff’s inaccuracies in reporting her previous use of benzodiazepines. (AR 22-23, citing
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AR 962 (December 13, 2023, record noting, “The patient did note that she tested positive
for benzodiazepines and as such was released from chronic pain management. The patient
denied ever taking benzodiazepines. I did note to the patient that we will not be continuing
her chronic care management regards to opiates.”); AR 839-40 (November 30, 2023, record
noting, “Patient was issued a final warning in 09/2023 . . . Since the patient is testing
positive for benzos 2 months past her final warning, I, unfortunately have to wean the
patient off narcotics…I advised the patient to f/u with their PCP in order to be referred to
a different pain management facility.”).
The ALJ also pointed out that Huff endorsed suffering “constant” diarrhea in her
function report but admitted at her administrative hearing that her use of the word
“constant,” a word the ALJ interprets as “24/7,” was an exaggeration. (AR 22, 63-64.) The
ALJ also relied on record evidence documenting “occasional loose stools” and normal
bowel movements in December 2022. (AR 22, citing AR 1037 (December 20, 2022, record
noting “occasional loose stools”); AR 1039 (December 5, 2022, record noting normal
bowel movement.)
This Court finds the ALJ’s reduced credibility determination based on symptom
exaggeration proper. See 20 C.F.R. § 404.1529(c)(4) (the ALJ will consider inconsistencies
between the claimant’s statements and the evidence of record); Tonapetyan v. Halter, 242
F.3d 1144, 1148 (9th Cir. 2001) (finding the claimant’s “tendency to exaggerate”
undermined her subjective complaints). Even if this Court were to determine that the ALJ’s
finding that Huff exaggerated her symptoms was improper, this Court would find the ALJ’s
reduced credibility determination support by specific, clear and convincing reasons based
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upon the other reasons relied upon by the ALJ. See Tonapetyan, 242 F.3d at 1048 (holding
“[e]ven if [the court] discount[ed] some of the ALJ's observations of Tonapetyan's
inconsistent statements and behavior, which might have innocent explanations as
Tonapetyan contends, [the court is] still left with substantial evidence to support the ALJ's
credibility determination.”).
Objective Medical Evidence
The United States Court of Appeals for the Ninth Circuit recognized, “[w]hen
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; 20 C.F.R. § 404.1529(c)(2). Huff argues that “the ALJ”s citation of unremarkable
findings amid other remarkable findings consistent with [her] allegations is not a clear and
convincing reason to find her statements inconsistent with the record.” (Doc. 14 at p. 12.)
This Court disagrees.
As the Commissioner points out, the ALJ found that despite Huff’s complaints of
debilitating pain, she did not consistently exhibit tenderness to palpitation of her spine, had
negative straight leg raises, and exhibited full strength and sensation in her lower
extremities. (AR 23, citing AR 874-75 (March 17, 2023, record from provider Mark E.
Cameron, ACNPG-AG); AR 895 (January 12, 2023, record from provider Samuel V.
Crandell, PA-C); AR 1102 (March 5, 2023, record from provider Dr. Anderson). The ALJ
noted many normal findings during Huff’s consultative examination with Jerri Hassman,
M.D., including unremarkable gait, her ability to bend forward, normal balance, full range
of motion in cervical spine, upper extremities, and lower extremities, no tenderness of
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cervical or lumbar spine, negative straight leg tests, and negative Phalen’s, Tinel’s, and
Finkelstein’s tests. (AR 24, citing AR 782-83 (consultative examiner Dr. Hassman’s
report).) The ALJ determined that Dr. Hassman’s findings contradict Huff’s testimony
regarding her limitations concerning her ability to walk, sit, stand, and bend over.
Regarding Huff’s cognitive issues, the ALJ relied on record evidence showing intact
memory, intact judgment and insight, normal mood and effect, and unimpaired thought
process and content. (AR 21, citing AR 875 (March 17, 2023, record from provider Mark
E. Cameron, ACNPG-AG); AR 895 (January 12, 2023, record from provider Samuel V.
Crandell, PA-C); AR 1033 (March 6, 2023, record from Farrell Roseberry, D.O.) The ALJ
compared Huff’s complaints of not being able to finish what she started and only being
able to concentrate for five minutes at a time with records from her providers that did not
find any deficits in concentration. (AR 21, citing AR 1102 (March 2, 2023, record of
neurological exam performed by Dr. Anderson.)
Huff points to other evidence in the record that supports her subjective symptom
testimony. (Doc. 14 at pp. 10-12.) However, this Court finds that Huff’s alternate
interpretation of the objective medical evidence does not negate the substantial evidence
supporting the ALJ’s decision. See Burch v. Barnhart, 400 F.3d 676, 679 (9th Cir. 2005)
(where evidence is susceptible to more than one rational interpretation, it is the ALJ’s
conclusion that must be upheld). This Court rejects Huff’s claim that the ALJ improperly
engaged in cherry-picking the record. (Doc. 14 at p. 12.) A reading of the ALJ’s decision
reflects that the ALJ acknowledged the record was mixed and this Court finds no legal
error in the ALJ’s determinations.
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In sum, this Court finds the ALJ’s reduced credibility determination is supported by
specific, clear and convincing reasons.
The ALJ Did Not Err in Considering the Consultative Examiners’ Opinions
Huff argues that opinion evidence from consultative examining sources Dr.
Hassman and MaryAnn Belton, Psy.D., is consistent with a finding of disability. (Doc. 14
at p. 17.) She argues that the ALJ’s findings with respect to Dr. Hassman and Dr. Belton
do not adequately address consistency and supportability as required by appliable
regulations. Id. As explained below, this Court rejects Huff’s argument.
Legal Standard
Under 20 C.F.R. § 404.1520c(a), the Commissioner “will not defer or give any
specific evidentiary weight, including controlling weight, to any medical opinion(s) or
prior administrative medical finding(s), including those from [the claimant's] medical
sources.” 20 C.F.R. 404.1520c(a). Section 404.1520c(c), 20 C.F.R., provides that when a
medical source provides one or more medical opinions, the Commissioner will consider
those medical opinions from that medical source together using the factors such as: (1)
supportability; (2) consistency; (3) relationship with the claimant, including the length of
the treatment relationship, the frequency of examinations, purpose and extent of the
treatment relationship, and the examining relationship; (4) specialization; and (5) any other
factors that “tend to support or contradict a medical opinion or prior administrative medical
finding.” Id. at § 404.1520c(c). The most important factors are supportability and
consistency. 20 C.F.R. § 404.1520c(a).
The regulations explain that as to supportability, “[t]he more relevant the objective
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medical evidence and supporting explanations presented by a medical source are to support
his or her medical opinion(s) or prior administrative medical finding(s), the more
persuasive the medical opinions or prior administrative medical finding(s) will be.” Id. at
§ 404.1520c(c)(1). With respect to consistency, “[t]he more consistent a medical opinion(s)
or prior administrative medical finding(s) is with the evidence from other medical sources
and nonmedical sources in the claim, the more persuasive the medical opinion(s) or prior
administrative medical finding(s) will be.” Id. at § 404.1520c(c)(2).
Dr. Hassman Consultative Examination
On September 4, 2022, Dr. Hassman observed minimal heel walking, inability to
stand or walk on toes due to metacarpal fusion, inability to hop, numbness in the left
fingers, and a log roll to change from supine to upright position. (AR 782-783.) Dr.
Hassman opined that Huff can perform a range of light work with occasional postural
abilities and occasional reaching based on evidence for left cervical radiculopathy and
cervical stenosis following the cervical diskectomy and fusion. (AR 785-786.) In
considering the opinion of Dr. Hassman, the ALJ found as follows:
Dr. Hassman opined that the claimant could perform light work with no
limitations in standing or walking or sitting (8F/5-6). She opined that the
claimant is able to occasionally climb ramps and stairs, ladders, ropes and
scaffolds, kneel, crouch, crawl, and reach, with frequent stooping (8F/6). Her
opinion is partially persuasive as it is somewhat consistent with the evidence
of record documenting positive cervical and lumbar facet loading maneuvers,
reduced range of motion in the neck, and limited range of motion in the upper
and lower bilateral extremities (12F/20;16F/74). Her opinion is consistent
with tenderness to palpation within the cervical paraspinal musculature
(13F/11). However, I find greater limitation in the claimant’s ability to reach
and feel based on the totality of the evidence and the findings of Dr.
Hassman’s examination. Dr. Hassman’s findings are not fully supported by
her examination as she does not identify any feeling limitation despite
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finding reduced sensation.
(AR 27.)
Dr. Hassman Analysis
Dr. Hassman opined, in relevant part, that Huff is limited to occasional reaching.
(AR 786.) However, Dr. Hassman did not specify whether her opined reaching limitation
is specific to any direction, e.g., front, lateral, or overhead. In his non-disability
determination, the ALJ recognized Dr. Hassman’s opinion, found “greater limitation in
[Huff’s] ability to reach and feel,” and therefore limited Huff to occasional overhead
reaching. (AR 27.)
Huff argues that the ALJ impermissibly “deviated” from Dr. Hassman’s opinion
that she was limited to occasional reaching. (Doc. 14 at p. 17.) She urges that the ALJ erred
in limiting her to occasional reaching “overhead with the bilateral upper extremities” when
Dr. Hassman limited her “generically” to occasional reaching. Id. at pp. 17-18.
It is the ALJ’s responsibility to translate medical opinions into concrete, functional
limitations. Rounds v. Comm’r, Soc. Sec. Admin., 807 F.3d 996, 1006 (9th Cir. 2015)
(recognizing that “the ALJ is responsible for translating and incorporating clinical findings
into a succinct RFC.”). An ALJ’s RFC limitations need not directly match the limitations
from an opinion or a medical source. See Vertigan v. Halter, 260 F.3d 1044, 1049 (9th Cir.
2001) (finding that “it is clear that it is the responsibility of the ALJ, not the claimant’s
physician, to determine [RFC]”); Hernandez v. O’Malley, No. 23-15509, 2024 WL
1596463, at *2 (9th Cir. Apr. 12, 2024) (holding ALJ permissibly found opinions
persuasive “without adopting them wholesale and to the exclusion of other relevant
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evidence.”); Mills v. Comm’r of Soc. Sec., No. 2:13-CV-0899-KJN, 2014 WL 4195012, at
*4 (E.D. Cal. Aug. 22, 2014) (recognizing “it is the ALJ’s responsibility to formulate an
RFC that is based on the record as a whole, and thus the RFC need not exactly match the
opinion or findings of any particular medical source.”)
This Court agrees with the Commissioner that the ALJ appropriately incorporated
Dr. Hassman’s assessed limitations regarding Huff’s ability to reach into the RFC
considering all the evidence in the record. As pointed out by the Commissioner, there are
several opinions on Huff’s reaching capacity. For example, as explained in his non-
disability determination, the ALJ found the opinion of state agency medical consultant
Amita Hegde, M.D., persuasive. (AR 26.) Dr. Hegde opined, in relevant part, that Huff was
not limited in her ability to reach in front and/or laterally but that she was limited in her
ability to reach overhead. (AR 26, citing AR 99.) This Court finds that the ALJ properly
considered the supportability and consistency of Dr. Hassman’s opinion.
This Court also agrees with the Commissioner that Huff fails to establish that any
error in the ALJ’s consideration of Dr. Hassman’s opinion was prejudicial. Huff lays out
that the Selected Characteristics of Occupations Defined in the Revised Dictionary of
Occupational Titles defines “reaching” as “[e]xtending hand(s) and arm(s) in any
direction.” (Doc. 19 at p. 4, citing Physical Demands, SCODICOT Appendix C.) She
argues that “[t]he ALJ’s redefinition of Dr. Hassman’s unambiguous opinion about
occasional ‘reaching’ to […] mean ‘occasional overhead reaching’ is unsupported by law.”
(Doc. 19 at pp. 4-5) (emphasis in original).
At the administrative hearing, the vocational expert testified that “for consideration
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of type of reaching and use of one extremity apart from the other [she] supplement[ed] the
references with [her] professional experience.” (AR 77.) Thus, the vocational expert did
not rely on the Dictionary of Occupational Title’s definition of reaching when she opined
that Huff can perform the occupations of small parts assembler, inspector, and garment
sorter. Id. The ALJ recognized this in his non-disability decision. See AR 28 (ALJ stating,
“I have determined that the vocational expert’s testimony is consistent with . . . the
Dictionary of Occupational Titles, except that the vocational expert relied on her education,
professional training, and experience to determine the impact of limitations not addressed
in the DOT, such as type of reaching, [and] use of one extremity versus both[.]”).
This Court finds the ALJ’s consideration of Dr. Hassman’s opinion legally
supported.
Dr. Belton’s First Consultative Examination
On August 26, 2022, Dr. Belton conducted the first of two consultative
examinations. Huff is recorded as explaining that she experiences “brain block,” such that
“when the pain is bad, my brain wants to shut down.” (AR 772.) She is recorded as
ambulating slowly but independently with wide-based gait. Dr. Belton recorded that Huff
had to be frequently asked to elaborate or offer details on her statements. (AR 773.) Dr.
Belton recorded a labile affect. Id. Huff achieved a 23/28 on the mini mental status
examination. (AR 776.) Dr. Belton diagnosed persistent depressive disorder with a rule/out
diagnosis of somatoform disorder. (AR 777.) Dr. Belton opined that Huff would have
“challenges with the execution of basic cognitive skills” while “symptoms are active.” (AR
778.) Dr. Belton also opined that Huff would have difficulty remaining on task and paying
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attention to novel stimuli when symptomatic and that Huff’s ability to respond quickly and
efficiently to supervisor requests would be compromised. Id. Dr. Belton stated that Huff
would struggle to navigate unpredictable work scenarios and solve problems. (AR 779.)
Dr. Belton’s Second Consultative Examination
On March 20, 2023, Dr. Belton performed a second consultative examination. This
time Huff scored 22/30 on the mini mental status examination. (AR 807.) Dr. Belton
observed that Huff had not remembered their previous interview and her difficulty with
memory had worsened over time. (AR 810.) Huff’s attention level was recorded as variable
and influenced by report and observation of pain. Huff’s affect was recorded as restricted
and she was recorded as indifferent and apathetic. Dr. Belton indicated that Huff would
struggle to respond quickly and appropriately within a work environment and that she
would be slower responding to changes in the environment. (AR 810-811.)
Regarding the opinions of Dr. Belton, the ALJ found as follows:
Dr. Belton opined that the claimant would have challenges with the execution
of basic cognitive skills involving encoding, storing, consolidating, and
retrieving information (7F/8). She opined that the claimant would have
difficulty remaining on task and her capacity to pay attention and attend to
stimuli would be compromised (7F/8). She opined that the claimant would
be compromised in her ability to respond to supervisory requests and would
struggle to navigate an unpredictable work scenario and have difficulty with
implementing an action plan (7F/9). In March 2023, Dr. Belton’s findings
were vague and she stated that the claimant performed below expectation and
her attention was variable (10F/6). She stated that the claimant would be
slower to respond to changes in the environment (10F/7). Dr. Belton’s
opinion is not completely consistent with the evidence of record as she found
that the claimant would have difficulty executing basis cognitive skills
(10F/7). Further, her opinion is not specific as to the claimant’s maximum
residual capacity. Her opinion is not completely consistent with the evidence
that the claimant’s depressive symptoms improved with medication and she
had generally normal mental status examinations in the record (6F/4; 13F/12,
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32; 16F/74). Her opinion is not fully supported by the examination which
found some difficulty with recall and 22-23/30 on mental status examination.
(AR 26-27.)
Dr. Belton Analysis
Huff argues that her normal psychiatric examinations were consistent with “Dr.
Belton’s more nuanced findings,” and asserts that the ALJ did not sufficiently explain
supportability and consistency. (Doc. 14 at pp. 18-20.) Contrary to Huff’s assertion, the
ALJ found that Dr. Belton’s significant limitations, such as challenges with the “execution
of basic cognitive skills,” were not supported by the examination findings which showed
some difficulty with recall and a score of 22-23/30 on the mini mental status examination.
(AR 27, citing AR 776, 778 (Dr. Belton’s August 2022 examination report); AR 807-08
(Dr. Belton’s March 20, 2023, examination report.)
As to the consistency of Dr. Belton’s opinions, the ALJ found Dr. Belton’s assessed
limitations were not consistent with evidence of Huff’s mental symptom improvement with
medication. This Court has outlined some of the records documenting Huff’s improvement
with medication above. Dr. Belton’s assessed limitations are also not consistent, as the ALJ
found, with Huff’s generally normal mental status examinations elsewhere in the record.
(AR 26-27, citing AR 575 (June 14, 2022, progress record by provider Trent Batty, M.D.,
recording, inter alia, “she is much more calm and content” and that “[s]he is working on
memory retaining applications on her iPad and trying everything she can to maintain her
memory.”); AR 875 (March 17, 2023, record of Mark E. Cameron, ACHPC-AG); AR 895
(January 12, 2023, record of Samuel V. Crandell, PA-C, recording, inter alia, “Thought
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Process: Not impaired. Attention demonstrated no abnormalities[,] Thought Content:
Revealed no impairment.”); AR 1033 (March 6, 2023, office visit record of Ferrell
Roseberry, D.O., recording, inter alia, “Psychiatric: Oriented X3, intact recent and remote
memory, judgment and insight, normal mood and affect.”)
The ALJ also determined that Dr. Belton’s opinions were not sufficiently specific
regarding Huff’s maximum residual capacity. (AR 26.) Dr. Belton’s opined limitations are,
according to Dr. Belton, appropriate “when symptoms are active.” Huff admits that this is
a “non-specific part” of Dr. Belton’s opinion. (Doc. 14 at p. 19.) However, Huff argues
that because the ALJ foreclosed questions on “the frequency with which Ms. Huff’s
symptoms of psoriatic arthritis flared . . . the frequency with which Dr. Belton’s opinion
applies is undefined because the ALJ excluded evidence defining it.” Id.
This Court does not see it Huff’s way. The ALJ limited Huff (not Dr. Belton as
Huff’s argument suggests) from testifying as to whether her symptoms are related to a
specific diagnosis. (AR 69.) The ALJ stated, in relevant part, “I can’t let her [Huff] draw
any causal connection between what you believe is diagnosis and her symptoms.” (AR 69.)
The ALJ advised Huff’s representative that Huff could be asked about her symptoms. Id.
This Court recognizes that Huff argues for a different interpretation of Dr. Belton’s
opinion. (Doc. 14 at pp 18-20.) However, she must do more than point to some record
evidence that could support her interpretation of the evidence. See Biestek v. Berryhill, 587
U.S. 97, 103, 139 S. Ct. 1148, 1154, 203 L. Ed. 2d 504 (2019) (recognizing that “whatever
the meaning of ‘substantial’ in other contexts, the threshold for such evidentiary sufficiency
is not high. Substantial evidence, this Court has said, is ‘more than a mere scintilla[]’ . . .
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It means—and means only—“such relevant evidence as a reasonable mind might accept as
adequate to support a conclusion.” (cleaned up).) Huff must show that based upon the
evidence contained in the record no reasonable fact finder could have drawn the same
conclusions as the ALJ. This Court finds that Huff has not done so.
RECOMMENDATION
For the foregoing reasons, it is RECOMMENDED that the district court AFFIRM
the decision of the ALJ. Pursuant to Federal Rule of Civil Procedure 72(b)(2), any party
may serve and file written objections within fourteen days of being served with a copy of
the Report and Recommendation. A party may respond to the other party’s objections
within fourteen days. No reply brief shall be filed on objections unless leave is granted by
the District Court. If objections are not timely filed, they may be deemed waived. If
objections are filed, the parties should use the following case number: 25-cv-00198-JGZ.
Dated this 11th day of May, 2026.
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