G. MURRAY SNOW, Chief District Judge.
At issue is the Commissioner of Social Security ("Commissioner")'s denial of Plaintiff Timothy Earl O'Neil ("Plaintiff")'s application for Title II disability insurance benefits. Plaintiff filed a Complaint (Doc. 1) seeking judicial review of that denial, and the Court now considers Plaintiff's Opening Brief (Doc. 13, "Pl. Br."), Commissioner's Response (Doc. 17, "Def. Br."), Plaintiff's Reply (Doc. 18), and the Administrative Record (Doc. 11, "R."). Because the Court finds the denial free of legal error and supported by substantial evidence, it affirms.
Plaintiff filed an application for Title II disability insurance benefits on March 16, 2015 for a period of disability beginning February 16, 2015 (later amended to July 1, 2015).
In finding Plaintiff not disabled, the ALJ determined:
(R. at 21.) In formulating this residual functional capacity ("RFC"), the ALJ gave "significant weight" to the opinion of Dr. Donald Fruchtman, a consultative examining physician, while assigning only "little" or "no weight" to the opinions of Dr. M.A. Kazmi, Plaintiff's treating neurologist. (R. at 25-26.) The ALJ had also rejected Plaintiff's subjective pain and symptom testimony and gave only "some" weight to subjective testimony from his family and friends. (R. at 21, 26-27.)
A vocational expert ("VE") testified at the hearing. (R. at 114-121.) The VE testified that an individual with Plaintiff's RFC could perform past relevant work as a compliance director. (R. at 116-117.) The VE further testified, however, that if that individual were to be off task for 10% or more of the workday or consistently miss two days of work per month, that individual would not be able to sustain full-time employment. (R. at 117-118.) Moreover, if such an individual could only occasionally handle or finger, he would not be able to perform the past relevant work since such work requires the ability to use a computer. (R. at 118.) The ALJ found non-disability on the basis of the first hypothetical. (R. at 27.)
In determining whether to reverse an ALJ's decision, the district court reviews only those issues raised by the party challenging the decision. See Lewis v. Apfel, 236 F.3d 503, 517 n.13 (9th Cir. 2001). The Court may set aside the Commissioner's disability determination only if it is not supported by substantial evidence or is based on legal error. Orn v. Astrue, 495 F.3d 625, 630 (9th Cir. 2007). "Substantial evidence" is more than a scintilla, but less than a preponderance; it is relevant evidence that a reasonable person might accept as adequate to support a conclusion considering the record as a whole. Id. "[T]he key question is not whether there is substantial evidence that could support a finding of disability, but whether there is substantial evidence to support the Commissioner's actual finding that claimant is not disabled." Jamerson v. Chater, 112 F.3d 1064, 1067 (9th Cir. 1997). The Court "must consider the record as a whole and may not affirm simply by isolating a specific quantum of supporting evidence." Orn, 495 F.3d at 630. "Where the evidence is susceptible to more than one rational interpretation, one of which supports the ALJ's decision, the ALJ's conclusion must be upheld." Thomas v. Barnhart, 278 F.3d 947, 954 (9th Cir. 2002).
To determine whether a claimant is disabled for purposes of the Act, the ALJ follows a five-step process.
The issues before the Court are: (1) whether the ALJ properly rejected the opinions of Dr. Kazmi, a treating physician; (2) whether the ALJ properly rejected Plaintiff's pain and symptom testimony; and (3) whether the ALJ properly rejected lay testimony from Plaintiff's family.
The determination of a claimant's RFC is an issue reserved to the Commissioner. 20 C.F.R. § 404.1527(d)(2). In formulating the RFC, the ALJ evaluates all medical opinions in the record and assigns a weight to each. 20 C.F.R. §§ 404.1527(b), 404.1527(c). The weight the ALJ gives an opinion depends on a variety of factors, namely: whether the physician examined the claimant; the length, nature, and extent of the treatment relationship (if any); the degree of support the opinion has, particularly from medical signs and laboratory findings; the consistency of the opinion with the record as a whole; the physician's specialization; and "other factors." 20 C.F.R. §§ 404.1527(c)(1)-404.1527(c)(6). Additionally, "[i]n conjunction with the relevant regulations, [the Ninth Circuit has] developed standards that guide [the] analysis of an ALJ's weighing of medical evidence." Ryan v. Comm'r of Soc. Sec., 528 F.3d 1194, 1198 (9th Cir. 2008). Generally, the greatest evidentiary weight is given to opinions of treating physicians; lesser weight is given to opinions of non-treating, examining physicians; and the least weight is given to opinions of non-treating, non-examining physicians. See Garrison v. Colvin, 759 F.3d 995, 1012 (9th Cir. 2014). A treating physician's opinion is entitled to the most weight because he or she "is employed to cure and has a greater opportunity to know and observe the patient as an individual." Sprague v. Bowen, 812 F.2d 1226, 1230 (9th Cir. 1987); see also 20 C.F.R. § 404.1527(c)(2).
An ALJ must resolve any conflicts between medical opinions. Morgan, 169 F.3d at 601. The ALJ may assign lesser weight to a controverted opinion of a treating physician if the ALJ articulates "specific and legitimate reasons supported by substantial evidence." Lester, 81 F.3d at 830. An ALJ may reject any medical opinion that is "brief, conclusory, and inadequately supported by clinical findings." Thomas, 278 F.3d at 957; see Batson v. Comm'r of Soc. Sec. Admin., 359 F.3d 1190, 1195 (9th Cir. 2004) (affirming rejection of a treating physician's opinion that "was in the form of a checklist, did not have supportive objective evidence, was contradicted by other statements and assessments of [claimant's] medical condition, and was based on [claimant's] subjective descriptions of pain"). An ALJ satisfies the "substantial evidence" requirement by providing a "detailed and thorough summary of the facts and conflicting clinical evidence, stating [her] interpretation thereof, and making findings." Garrison, 759 F.3d at 1012. "The opinions of non-treating or non-examining physicians may also serve as substantial evidence when the opinions are consistent with independent clinical findings or other evidence in the record." Thomas, 278 F.3d at 957; see also Tonapetyan v. Halter, 242 F.3d 1144, 1149 (9th Cir. 2001) (finding examining physician's opinion constituted "substantial evidence" because it was based on his own independent examination of claimant).
Dr. M.A. Kazmi, Plaintiff's treating neurologist, completed a "Physical Residual Functional Capacity Questionnaire" on July 9, 2015. (R. at 1070-74.) Therein, he opined Plaintiff could only sit, stand, or walk for less than two hours in an eight-hour work day and would require a job that permitted him to shift positions at will and take unscheduled breaks throughout the day. (R. at 1072.) He further opined Plaintiff could "rarely" carry and lift up to ten pounds and could "never" carry or lift anything ten pounds or more. (R. at 1072.) Plaintiff also could "never" look down, turn his head right or left, look up, or hold his head in a static position. (R. at 1073.) He also could "never" twist, stoop, crouch/squat, climb ladders, or climb stairs. (R. at 1073.) Further, Plaintiff had "significant limitations" with reaching, handling, and fingering. (R. at 1073.) Specifically, he could only use his hands to grasp, turn, or twist objects for 20% of the day; could only use his fingers for fine manipulations 5% of the day; and could only use his arms to reach for 5% of the day. (R. at 1073.) Dr. Kazmi opined that Plaintiff would miss work more than four days per month, which he further specified would be "almost every day." (R. at 1073.) Lastly, he opined Plaintiff would have "constant[]" difficulty concentrating due to pain or other symptoms. (R. at 1071.) Moreover, on January 26, 2016 and February 4, 2016, Dr. Kazmi wrote correspondence stating that Plaintiff was "unable to work in any capacity due to [his multiple medical conditions]." (R. at 1194-95.) Because Dr. Kazmi's opinion is in conflict with the opinion of Dr. Fruchtman, the ALJ's reasons for assigning it lesser weight must be "specific and legitimate" and supported by substantial evidence. Lester, 81 F.3d at 830.
The ALJ assigned "little weight" to Dr. Kazmi's opinions in the questionnaire, finding them "not supported by the objective clinical findings, including those contained in [his] own treatment notes." (R. at 25.) In support, the ALJ referenced notes from Dr. Kazmi's examination of Plaintiff on July 9, 2015, the same day he completed the questionnaire, wherein he noted Plaintiff had a "supple" neck with a "full range of motion," a "normal" gait, "normal strength in all four extremities," and "no deformities or abnormalities" in his extremities. (R. at 1078.) He made identical notations at every appointment from August 26, 2013, when he first examined Plaintiff, to July 9, 2015.
Likewise, the ALJ assigned "little weight" to Dr. Kazmi's opinion regarding Plaintiff's inability to concentrate (R. at 1071) as "not supported by objective testing" and "arguably. . . outside of his area of expertise." (R. at 26.) However, the Ninth Circuit has held that despite not being a mental health specialist, a physician may nonetheless provide a competent medical opinion as to his patient's mental functioning. Lester, 81 F.3d at 833. As such, the opinion may not be freely disregarded without a legally sufficient reason. Nevertheless, an ALJ may consider the specialization of a physician in determining how much weight to afford a medical opinion. 20 C.F.R. § 404.1527(c)(5) ("We generally give more weight to the medical opinion of a specialist about medical issues related to his or her area of specialty than to the medical opinion of a source who is not a specialist."). Moreover, the ALJ may consider the degree of support the medical opinion has from objective medical evidence. 20 C.F.R. § 404.1527(c)(3). Here, prior to this assessment, there is no documentation by Dr. Kazmi of any impairment relating to Plaintiff's ability to concentrate, nor did Plaintiff ever complain to Dr. Kazmi about any issues with respect to concentrating or mental functioning in general. Thus, while the Court finds Dr. Kazmi's opinion regarding Plaintiff's ability to concentrate to be competent evidence despite it arguably being outside of Dr. Kazmi's specialty, it also finds the ALJ did not err in disregarding it for lack of supporting clinical evidence.
Additionally, Dr. Kazmi opined that Plaintiff would be absent from work for more than four days per month "as a result of impairments or treatment," further elaborating next to the box he checked that Plaintiff would be absent "almost every day." (R. at 1073.) The ALJ found this opinion "unpersuasive" for lack of an explanation as to how he arrived at this number. (R. at 26.) Specifically, there is no explanation as to how exactly Plaintiff's impairments would preclude him from being able to regularly show up for work. Moreover, as noted by the ALJ, "[t]reatment modalities have been conservative." (R. at 24.) Indeed, the record discloses that since the alleged date of onset, July 1, 2015, in not one month did Plaintiff see a doctor more than twice, at times even going as long as six months without seeing a doctor at all. Thus, there is no substantial evidence to support the conclusion that Plaintiff would miss "almost every day" of work due to treatment. The Court finds this opinion to be "brief, conclusory, and inadequately supported by clinical findings;" therefore, the Court finds no error in its dismissal. Thomas, 278 F.3d at 957.
Lastly, Dr. Kazmi wrote correspondence on January 26, 2016 and February 4, 2016 opining that Plaintiff was "unable to work in any capacity due to [his multiple medical conditions]." (R. at 1194-95.) The ALJ gave this correspondence "no weight," reasoning that it opined to an issue reserved to the Commissioner and "[n]othing in the record suggests that Dr. Kazmi has ever worked for or on behalf of the Social Security Administration or has any specialized vocational knowledge or familiarity to opine whether the claimant can perform work as it exists in the national economy." (R. at 26.) Indeed, whether an individual is "disabled" or "unable to work" is not a medical opinion but rather an "administrative finding" that is expressly reserved to the Commissioner. 20 C.F.R. § 404.1527(d)(1). Nevertheless, the ALJ may not ignore such opinions and may only disregard them for legally sufficient reasons according to the same standard for rejecting medical opinions. Reddick v. Chater, 157 F.3d 715, 725 (9th Cir. 1998); SSR-96-5P (S.S.A.), 1996 WL 374183, *3 (July 2, 1996). Within the correspondence, Dr. Kazmi merely states Plaintiff's impairments and a bare conclusion that Plaintiff is unable to work without discussing or referencing any particular medical evidence to support that conclusion, nor does Dr. Kazmi discuss what Plaintiff is capable of doing. Thus, because the subject matter of the letter solely regards the ultimate administrative finding of disability and nothing more, the ALJ did not err in rejecting it for the specific and legitimate reason that Dr. Kazmi did not possess the requisite administrative knowledge to opine to this issue.
Dr. Donald Fruchtman examined Plaintiff on December 10, 2015 at the behest of the Commissioner. (R. at 1184-92.) He observed that Plaintiff was able to get onto the exam table but that he became lightheaded upon standing. (R. at 1186.) Plaintiff had regular heart rate and rhythm. (R. at 1187.) Plaintiff did, however, have a significantly positive Romberg test
Based on his examination, Dr. Fruchtman opined that Plaintiff was able to "frequently" carry and lift 10 pounds but could only "occasionally" carry and lift 20 pounds. (R. at 1191.) He could stand or walk for at least four hours in an eight-hour workday and could sit for six to eight hours in an eight-hour workday without limitations. (R. at 1191.) He could "frequently" kneel, crawl, reach, and handle; and could "occasionally" climb, balance, stoop, or crouch. (R. at 1191.) Dr. Fruchtman also opined that Plaintiff could not work in extreme temperatures, with or around chemicals, around dust or gas fumes, or around excessive noise. (R. at 1192.) He further opined that Plaintiff was not precluded from working due to fatigue. (R. at 1192.)
The ALJ gave "significant weight" to Dr. Fruchtman's opinion, finding it "consistent with the objective clinical findings and the claimant's reports to his doctors, including the neurological deficits, orthostatic dizziness, and pain." (R. at 25.) The ALJ, however, did prescribe greater limitations than Dr. Fruchtman with respect to kneeling or crawling after considering Plaintiff's "subjective complaints of pain, fatigue, and dizziness" as well as "the neurological deficits persistently demonstrated on examination." (R. at 25.)
Because Dr. Fruchtman examined Plaintiff and based his opinions on that examination, his opinion constitutes substantial evidence that the ALJ was free to use to support her decision. See Thomas, 278 F.3d at 957; Tonapetyan, 242 F.3d at 1149.
Because the severity of an impairment may be greater than what can be shown by objective medical evidence alone, the ALJ considers a claimant's subjective testimony regarding pain and symptoms. 20 C.F.R. § 404.1529(c)(3); Burch v. Barnhart, 400 F.3d 676, 680 (9th Cir. 2005). The claimant, however, must still show objective medical evidence of an underlying impairment that could be reasonably be expected to produce the pain or symptoms alleged. 42 U.S.C. § 423(d)(5)(A); 20 C.F.R. § 404.1529(a); see also Fair v. Bowen 885 F.2d 597, 603 (9th Cir. 1989) ("An ALJ cannot be required to believe every allegation of disabling pain [and symptoms], or else disability benefits would be available for the asking, a result plainly contrary to 42 U.S.C. § 423(d)(5)(A)."). However, while such evidence is required to show the existence of an underlying impairment, "the [ALJ] may not discredit the claimant's testimony as to subjective symptoms merely because they are unsupported by objective evidence." Berry v. Astrue, 622 F.3d 1228, 1234 (9th Cir. 2010). Nevertheless, the ALJ evaluates the testimony in relation to the objective medical evidence and other evidence in determining the extent to which the pain or symptoms affect his capacity to perform basic work activities. 20 C.F.R. § 404.1529(c)(4).
Unless there is evidence of malingering by the claimant, the ALJ may only reject pain or symptom testimony for reasons that are specific, clear, and convincing. Burch, 400 F.3d at 680. In evaluating the credibility of a claimant's testimony, the ALJ may consider the claimant's "reputation for truthfulness, inconsistencies either in his testimony or between his testimony and his conduct, his daily activities, his work record, and testimony from physicians and third parties concerning the nature, severity, and effect of the symptoms of which he complains." Light v. Soc. Sec. Admin., Comm'r, 119 F.3d 789, 792 (9th Cir. 1997); see 20 C.F.R. § 404.1529(c)(4). General findings pertaining to a claimant's credibility are not sufficient. Lester, 81 F.3d at 821. Rather, "the ALJ must specifically identify the testimony she or he finds not to be credible and must explain what evidence undermines the testimony." Holohan v. Massanari, 246 F.3d 1195, 1208 (9th Cir. 2001). In doing so, the ALJ need not engage in "extensive" analysis but should, at the very least "provide some reasoning in order for [a reviewing court] to meaningfully determine whether [her] conclusions were supported by substantial evidence." Brown-Hunter v. Colvin, 806 F.3d 487, 494 (9th Cir. 2015). Nevertheless, if the ALJ explains her decision "with less than ideal clarity, a reviewing court will not upset the decision on that account if [her] path may reasonably be discerned." Alaska Dept. of Envtl. Conservation v. E.P.A., 540 U.S. 461, 497 (2004); see Brown-Hunter, 806 F.3d at 492 (applying this rule to the social security context).
Here, the ALJ cited no evidence of malingering and found Plaintiff had three underlying impairments: (1) diabetes mellitus with neuropathy, (2) orthostatic hypotension, and (3) lumbar and thoracic spine degenerative disc disease. (R. at 18.) The ALJ then summarized Plaintiff's testimony as follows:
(R. at 21, 95-111.) The ALJ rejected Plaintiff's testimony for two reasons. First, she found it "not entirely consistent with the medical evidence and other evidence in the record." (R. at 21.) The ALJ analyzed the evidence and testimony for each impairment separately.
First, with regards to Plaintiff's diabetes mellitus, the ALJ cited to a number of treatment records in finding that Plaintiff's pain and symptoms associated with diabetes mellitus were not work-preclusive. Specifically, she referenced the same previously discussed treatment notes from Dr. Kazmi where Plaintiff was noted as having a normal gait and normal strength in his extremities (R. at 1078), but additionally noting ones that indicated Plaintiff had weakness more prominent in the lower extremities and coordination issues upon sudden standing (R. at 1213). (R. at 23.) She also pointed out that Dr. Kazmi noted Plaintiff had difficulty ambulating without support and a normal gait but with the use of a cane. (R. at 1436.) However, she noted that a diabetic foot exam on August 26, 2016 was "normal." (R. at 23.)
The ALJ found that notwithstanding Plaintiff's complications due to diabetic neuropathy he is capable of working at the light exertional level. (R. at 22.) The ALJ prescribed the "light" exertional level, specifically recognizing that Plaintiff has persistent neurological deficits that affect his hands and feet. (R. at 22.) Moreover, she limited the amount of time he stands or walks to four hours, provided for use of a cane, proscribed work at heights and around other hazards, and limited the type and frequency of postural and manipulation activities to account for neurological deficits in his lower extremities. (R. at 23.) Thus, the Court finds no error in the ALJ's consideration of Plaintiff's testimony with respect to his diabetic neuropathy as she appropriately accommodated his limitations in the RFC. (R. at 21.)
Second, with regards to Plaintiff's orthostatic hypotension,
However, Plaintiff alleges the ALJ improperly disregarded his testimony regarding the intensity, persistence, and limiting effects of his orthostatic dizziness. Specifically, Plaintiff argues the ALJ's conclusion that he was "`doing good' from a cardiac perspective" (R. at 22) does nothing to undermine his testimony regarding the severity of his orthostatic dizziness. (Pl. Br. at 18.) He alleges that the orthostatic dizziness is "not cardiac related, but caused by autonomic neuropathy."
However, Plaintiff presented to Dr. Atassi, a cardiologist, for evaluation of his chest pain. (R. at 1210.) It was Plaintiff who told Dr. Atassi that his chest pain leads to dizziness. (R. at 1210.) Thus, Dr. Atassi was employed to diagnose and treat Plaintiff's dizziness. As such, the ALJ did not err in discussing and citing to records and opinions from Dr. Atassi as they were records relevant to Plaintiff's dizziness. Moreover, Plaintiff informs the Court that orthostatic hypotension entails a "decrease in systolic and diastolic blood pressure." (Pl. Br. at 3.) Thus, even a lay person, such as the ALJ, can make the rational interpretation that the heart, an organ which pumps blood, is implicated by orthostatic hypotension. For these reasons, the Court will not disturb the ALJ's rational interpretation of the record and finds no error in the ALJ's rejection of Plaintiff's testimony as it relates to his orthostatic hypotension.
Third, with regards to Plaintiff's degenerative disc disease, the ALJ noted, "a thoracic spine x-ray revealed straightening of the normal thoracic spine with no compression fracture or significant malalignment. It showed mild degenerative discogenic disease in the lower lumbar spine, but no spondylolisthesis or significant malalignment." (R. at 23, 1169.) The ALJ also noted, "a thoracic spine MRI revealed a disc protrusion at T7-8 and T8-9, otherwise it was unremarkable." (R. at 23, 1306.) She remarked that "the clinical findings from physician examinations do not support the degree of symptoms the claimant has alleged"; "the physician examinations primarily revealed neurological findings discussed above but showed little with regard to the claimant's spinal impairment." (R. at 23.)
Thus, the ALJ concluded that "the clinical findings reported in the progress notes focus on neurological signs; there is little in the way of orthopedic signs, such as decreased or painful range of motion, decreased strength,
The second reason the ALJ discounted Plaintiff's testimony was because Plaintiff "has not generally received the level of medical treatment one would expect for a disabled individual," noting that "[t]reatment modalities have been conservative." (R. at 24.) Specifically, the ALJ argued that "with claimant's alleged severity of pain and limitations, one would expect more significant findings on both the diagnostic imaging and exams, as well as more complex treatment." (R. at 24.) She noted that Plaintiff was never recommended surgery or underwent more invasive procedures, such as epidural injections or nerve ablations. (R. at 24.) This all stands for the ALJ's proposition that if Plaintiff's pain and symptoms were really as severe as alleged, he would be doing more for them, instead of merely taking "routine prescription medication" and engaging in other home remedies such as hydrotherapy and yoga. (R. at 24.)
This reason is sufficient. See Parra v. Astrue, 481 F.3d 742, 751 (9th Cir. 2007) ("[E]vidence of conservative treatment is sufficient to discount a claimant's testimony regarding severity of an impairment.") (internal quotations and citation omitted). An ALJ is free to take into account the amount of treatment a claimant receives for an impairment in determining the nature and severity of the impairment, as well as medication and any other measures used. 20 C.F.R. §§ 404.1529(c)(3)(iv)-404.1529(c)(3)(vi). Thus, the Court finds no error here.
The ALJ committed no legal errors in considering the entirety of Plaintiff's subjective testimony. Although a lack of objective medical evidence cannot be the sole basis on which a claimant's testimony is rejected, it is still a factor that the ALJ may consider. Burch, 400 F.3d at 681. Here, the lack of objective medical evidence showing "more significant findings on both the diagnostic imaging and exams" (R. at 24) in combination with Plaintiff's conservative treatment is sufficient to discount his testimony. Though, in actuality, the ALJ did not discount the entirety of his testimony. Rather, the ALJ had made appropriate accommodations and restrictions in the RFC to account for Plaintiff's subjective complaints. Simply because these complaints did not give rise to a finding of disability does not warrant a reversal where the ALJ rationally interpreted the record and based her conclusions on substantial evidence therein.
Nonmedical ("lay witness") sources may testify as to how a claimant's symptoms affect his activities of daily living and ability to work. 20 C.F.R. § 404.1529(a). Such testimony is "competent evidence" that an ALJ may not disregard unless he or she gives "reasons germane to each witness for doing so." Diedrich v. Berryhill, 874 F.3d 634, 640 (9th Cir. 2017) (internal quotations and citation omitted).
The record contains several lay opinions from Plaintiff's family and friends. (R. at 438-450, 486-487.) The ALJ gave "some weight" to all of the lay opinions collectively, reasoning that none of the witnesses "have the appropriate psychological or medical training to make exacting observations, diagnoses, and determine mental or physical limitations." (R. at 26-27.) Moreover, according to the ALJ, "[t]heir statements seem to identify the symptoms from the impairments, but the medical evidence and opinions do not fully support their opinions." (R. at 27.) Plaintiff disputes only the rejection of the opinions of his wife, Kathie O'Neil; son, Michael O'Neil; and sister-in-law, Terrie Sage. (Pl. Br. at 20.)
In her correspondence, Kathie O'Neil describes Plaintiff's inability to not sit or stand long, his need for something to hold onto for balance, his inability to use his hands effectively, and what his pain is like when he does not take his medication. (R. at 438.) Similarly, Michael O'Neil describes Plaintiff's inability to walk without support, his lightheadedness, his medication requirements, and his forgetfulness. (R. at 447-448.) Lastly, Terrie Sage also described Plaintiff's pain, loss of concentration, lack of balance, dizziness, and need for support. (R. at 442.)
Here, because the ALJ properly rejected Plaintiff's subjective complaints, the Court finds the lay third-party opinions are properly rejected as well as they regard similar symptoms and complaints thereof. See Valentine v. Comm'r Soc. Sec. Admin., 574 F.3d 685, 694 (9th Cir. 2009) (holding that because "the ALJ provided clear and convincing reasons for rejecting [the claimant's] own subjective complaints, and because [the claimant's] testimony was similar to such complaints, it follows that the ALJ also gave germane reasons for rejecting [the lay witness's] testimony").
