9th Circuit upholds denial of Social Security disability benefits for Amiee Sullens, finding the ALJ's…

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NOT FOR PUBLICATION FILED UNITED STATES COURT OF APPEALS JUL 15 2026 MOLLY C. DWYER, CLERK U.S. COURT OF APPEALS FOR THE NINTH CIRCUIT AMIEE SULLENS, No. 25-2252 D.C. No. Appellant, 2:24-cv-00804-JR v. MEMORANDUM* FRANK BISIGNANO, Commissioner of Social Security, Appellee. Appeal from the United States District Court for the District of Oregon Jolie A. Russo, Magistrate Judge, Presiding Submitted June 8, 2026** Portland, Oregon Before: CHRISTEN, HURWITZ, and BADE, Circuit Judges. Partial Concurrence and Partial Dissent by Judge Christen. Amiee Sullens appeals a district court judgment affirming a decision by an Administrative Law Judge (“ALJ”) denying her application for social security * This disposition is not appropriate for publication and is not precedent except as provided by Ninth Circuit Rule 36-3. ** The panel unanimously concludes this case is suitable for decision without oral argument. See Fed. R. App. P. 34(a)(2). disability insurance benefits and supplemental security income. “We review the district court’s order affirming the ALJ’s denial of social security benefits de novo and will disturb the denial of benefits only if the decision contains legal error or is not supported by substantial evidence.” Lambert v. Saul, 980 F.3d 1266, 1270 (9th Cir. 2020) (cleaned up). “Where evidence is susceptible to more than one rational interpretation, it is the ALJ’s conclusion that must be upheld.” Burch v. Barnhart, 400 F.3d 676, 679 (9th Cir. 2005). We have jurisdiction under 28 U.S.C. § 1291, and we affirm. 1. Sullens argues that the ALJ erred by failing to evaluate her incontinence at step two of the five-step sequential analysis. But the ALJ ruled in favor of Sullens at step two and discussed incontinence at steps three and four. Thus, any error was harmless. See Lewis v. Astrue, 498 F.3d 909, 911 (9th Cir. 2007); Buck v. Berryhill, 869 F.3d 1040, 1048–49 (9th Cir. 2017). 2. Sullens argues that the ALJ improperly relied on the absence of supportive medical evidence in discrediting her testimony about her symptoms. That is not accurate. Rather, the ALJ found her testimony inconsistent with the longitudinal medical record and consultants’ reports. See Smartt v. Kijakazi, 53 F.4th 489, 498 (9th Cir. 2022) (explaining that although “an ALJ cannot insist on clear medical evidence to support each part of a claimant’s subjective pain testimony,” “[w]hen objective medical evidence in the record is inconsistent with the claimant’s 2 25-2252 subjective testimony, the ALJ may indeed weigh it as undercutting such testimony”); Andrews v. Shalala, 53 F.3d 1035, 1041 (9th Cir. 1995) (“[R]eports of the nonexamining advisor . . . may serve as substantial evidence when they are supported by other evidence in the record and are consistent with it.”). The ALJ’s findings were based on substantial evidence in the record. Sullens reported to doctors that her condition was controlled by medication and that she did not experience joint swelling, joint pain flare ups, or medication side effects. The longitudinal medical record demonstrated that Sullens’s joint disease was stable, she had normal muscle strength and gait, she did not display acute distress, and she displayed full range of motion in her upper and lower extremities and could move them without pain or tenderness. Medical records also documented normal mood, affect, and ability to follow simple and complex tasks. See Nadon v. Bisignano, 145 F.4th 1133, 1137 (9th Cir. 2025) (affirming credibility finding where ALJ explained that claimant’s testimony of fibromyalgia pain “was inconsistent with evidence indicating that her symptoms improved with conservative treatment” and “that she had mostly normal examinations”); SSR 12-2p, 77 Fed. Reg. 43640, 43642 (July 25, 2012) (noting “longitudinal records reflecting ongoing medical evaluation and treatment” are “especially helpful” when a person alleges fibromyalgia). Substantial evidence also supports the ALJ’s findings as to Sullens’s claims of incontinence. Sullens’s urologist concluded that because she had a “completely 3 25-2252 normal-appearing bladder and urethra,” any incontinence might “simply reflect an overactive bladder, or excess caffeine consumption.” Likewise, her abdominal x- rays indicated “nonobstructive bowel gas pattern,” and her defecography results noted “mild decreased motility within the rectum.” In addition, the ALJ reasonably considered the normal results from the gastric emptying study which were consistent with the absence of dumping syndrome, a disorder associated with diarrhea.1 3. Sullens argues the ALJ erred at step three of the sequential analysis, and the evidence requires a finding that her impairments meet or equal listed impairments.2 We find no error. a. First, Sullens failed to provide the required medical evidence that her fibromyalgia equaled a listed impairment, and there was no “prior administrative medical finding . . . supporting the medical equivalence finding,” or a “report from the [Appeals Council’s] medical support staff.” SSR 17-2p, 82 Fed. Reg. 15263, 1 See Kevin P. Banks et. al., Scintigraphy of Gastrointestinal Motility: Best Practices in Assessment of Gastric and Bowel Transit in Adults, 44 RadioGraphics e230127 (2024), https://doi.org/10.1148/rg.230127 [https://perma.cc/RV2W-7X6V]; Silvana Obici, Understanding Dumping Syndrome: Symptoms, Diet and Treatment Guide, Stony Brook Med. Health News (Sept. 26, 2025), https://health.stonybrookmedicine.edu/understanding-dumping- syndrome-symptoms-diet-and-treatment-guide. [https://perma.cc/U3HU-A2MP] 2 Because fibromyalgia is not a listed impairment, the issue is whether it “medically equals a listing . . . or whether it medically equals a listing in combination with at least one other medically determinable impairment.” SSR 12-2p, 77 Fed. Reg. at 43644. 4 25-2252 15265 (Mar. 27, 2017); see also 42 U.S.C. § 423(d)(5)(A) (“An individual shall not be considered to be under a disability unless he furnishes such medical and other evidence of the existence thereof as the Commissioner of Social Security may require.”). b. Second, the ALJ’s conclusions were supported “at a later step in the sequential evaluation process” in the RFC analysis. SSR 17-2p, 82 Fed. Reg. at 15265; see also Lewis v. Apfel, 236 F.3d 503, 513 (9th Cir. 2001) (finding no error where ALJ supported step three conclusion under a different section). Those findings were supported by medical evidence that Sullens could move her extremities without pain or tenderness and had a normal gait. Sullens also reported to doctors that she was not in acute distress or experiencing flares of joint pain or swelling. Substantial evidence also supports the ALJ’s determination that Sjogren’s syndrome did not equal a listed impairment, given medical records describing Sullens’s symptoms as “mild” and manageable with eye flushes. 4. At step five, a vocational expert (“VE”) identified jobs that Sullens could perform t

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