MEMORANDUM **
Tina Downs appeals from the district courts judgment affirming a decision of the Commissioner of Social Security that she is not entitled to disability insurance benefits. We have jurisdiction under 28 U.S.C. § 1291 and 42 U.S.C. § 405(g). Reviewing the administrative law judges (“ALJ”) findings for substantial evidence, see Luther v. Berryhill, 891 F.3d 872, 875 (9th Cir. 2018), we affirm.
1. Any error by ALJ Kennedy in invoking the law of the case was harmless because we can review the merits of ALJ Alexiss findings in light of the additional evidence Downs presented to ALJ Kennedy on remand. See Buck v. Berryhill, 869 F.3d 1040, 1050 (9th Cir. 2017); cf. Askins v. U.S. Dept of Homeland Sec., 899 F.3d 1035, 1043 (9th Cir. 2018) (reviewing in the first instance whether amended complaint was adequately pled after district court erroneously relied on the law of the case to dismiss it).
2. ALJ Kennedy did not need to evaluate whether Downss new evidence of pain showed a “severe medically determinable ․ impairment,” 20 C.F.R. § 416.920(a)(4)(ii), in light of his conclusion that pain is a symptom rather than a medically determinable impairment. See 20 C.F.R. § 404.1529(b) (“Your symptoms, such as pain ․ , will not be found to affect your ability to do basic work activities unless medical signs or laboratory findings show that a medically determinable impairment(s) is present.”). The ALJ acknowledged Downss new evidence of fibromyalgia and chronic fatigue syndrome and properly rejected it for failing to rule out other possible conditions with the same symptoms. See SSR 12-2p, 77 Fed. Reg. 43,640, 43,641 (July 25, 2012); SSR 14-1p, 79 Fed. Reg. 18,750, 18,752 (Apr. 3, 2014). The ALJ gave germane reasons for rejecting Downss new evidence of anxiety and sleep disturbance. See 20 C.F.R. § 404.1502(a) (excluding nurse practitioners from “[a]cceptable medical source[s]” for Downss claim); Valentine v. Commr Soc. Sec. Admin., 574 F.3d 685, 694 (9th Cir. 2009).
In discounting most of the examining doctors’ opinions, the ALJ provided “specific and legitimate reasons” supported by substantial evidence in the record. Ford v. Saul, 950 F.3d 1141, 1154 (9th Cir. 2020) (quoting Lester v. Chater, 81 F.3d 821, 830 (9th Cir. 1995)). Dr. Henry-Socha was uncertain about a diagnosis for Downss pain, see Tonapetyan v. Halter, 242 F.3d 1144, 1150–51 (9th Cir. 2001), and failed to indicate vocational restrictions, see Ford, 950 F.3d at 1156. Dr. Tolles and ARNP Griffel made vague assessments of Downss anxiety that lacked specific vocational restrictions, and their treatment notes during the relevant period did not support the significant limitations they assessed more than two years after Downss benefits eligibility expired. Dr. Mays and Dr. Kaufmans fibromyalgia diagnoses did not rule out other possible causes of Downss symptoms. Dr. Earles opinion did not indicate any vocational restrictions.
To the extent ALJ Alexis erred in rejecting Dr. Rubensteins diagnosis of thoracic outlet syndrome, the error was harmless. Dr. Rubenstein described the condition as “sporadic,” and ALJ Kennedy acknowledged Downss “complaints of ․ numbness in the extremities” and “considered [Downss] symptoms as reflected in the longitudinal record in evaluating her testimony and in formulating the residual functional capacity.”
3. ALJ Kennedy offered “specific, clear and convincing reasons” for rejecting Downss testimony about the severity of her symptoms. Garrison v. Colvin, 759 F.3d 995, 1014–15 (9th Cir. 2014) (quoting Smolen v. Chater, 80 F.3d 1273, 1281 (9th Cir. 1996)). Downs testified that she had migraines “every single day” from 2010 to 2015, with blurred vision “at least four days a week,” and vomiting “[s]ometimes.” However, in January 2011 Downs reported experiencing migraines “weekly,” and in April 2014 she reported that her headaches were “stable” and that she used prescription medication only “occasionally for severe [ones].” Throughout the alleged disability period, Downs almost always denied having vision problems or nausea.
Downs received only conservative treatment for her back and neck pain. “[E]vidence of ‘conservative treatment’ is sufficient to discount a claimants testimony regarding severity of an impairment.” Parra v. Astrue, 481 F.3d 742, 751 (9th Cir. 2007) (quoting Johnson v. Shalala, 60 F.3d 1428, 1434 (9th Cir. 1995)). Downs typically denied experiencing mental health symptoms to her primary care provider, and there is little evidence that she sought specialized treatment, suggesting that her occasional symptoms were not severe. Downss frequent denials of fatigue to medical providers was inconsistent with her allegations of fatigue and a need to nap for two to three hours each day.
4. In discounting the testimony of the other lay witnesses—Ben Downs, Cheryl Moore, and Melinda Gauyan—the ALJs gave reasons that were “germane to each witness.” Valentine, 574 F.3d at 694 (quoting Dodrill v. Shalala, 12 F.3d 915, 919 (9th Cir. 1993)). Downs acknowledges that Ben Downss observations were “consistent with [her own] testimony,” and ALJ Kennedy properly rejected them for the same reasons. See id. Similarly, both ALJ Kennedy and ALJ Alexis properly found that Moores statements were not entirely consistent with the medical evidence for the same reasons as Downss testimony. And ALJ Alexis properly found that Gauyans description of Downss difficulties at work was not helpful because the work “was at a much higher difficulty level than” that required by Downss residual functional capacity.
5. Because ALJ Kennedy did not err in evaluating the record evidence, he properly assessed Downss residual functional capacity.
AFFIRMED.