Eby v. Kijakazi, No. 1:2022cv03065 - Document 17 (E.D. Wash. 2022)
Court Description: ORDER denying Plaintiff's 11 Motion for Summary Judgment and granting Defendant's 12 Motion for Summary Judgment. Signed by Judge Thomas O. Rice. (BF, Paralegal)
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Eby v. Kijakazi Doc. 17 Case 1:22-cv-03065-TOR ECF No. 17 filed 12/20/22 PageID.510 Page 1 of 15 1 2 3 4 UNITED STATES DISTRICT COURT 5 EASTERN DISTRICT OF WASHINGTON 6 7 ANGELINA R. E., NO. 1:22-CV-3065-TOR Plaintiff, 8 9 10 v. KILOLO KIJAKAZI, Acting Commissioner of Social Security, ORDER DENYING PLAINTIFF’S MOTION FOR SUMMARY JUDGMENT AND GRANTING DEFENDANT’S MOTION FOR SUMMARY JUDGMENT 11 Defendant. 12 13 BEFORE THE COURT are the parties’ cross-motions for summary 14 judgment (ECF Nos. 11, 12). Plaintiff is represented by D. James Tree. Defendant 15 is represented by SAUSA David J. Burdett. This matter was submitted for 16 consideration without oral argument. The Court has reviewed the administrative 17 record and the parties’ completed briefing and is fully informed. For the reasons 18 discussed below, the Court DENIES Plaintiff’s motion and GRANTS Defendant’s 19 motion. 20 ORDER DENYING PLAINTIFF’S MOTION FOR SUMMARY JUDGMENT AND GRANTING DEFENDANT’S MOTION FOR SUMMARY JUDGMENT ~ 1 Dockets.Justia.com Case 1:22-cv-03065-TOR 3 4 5 filed 12/20/22 PageID.511 Page 2 of 15 JURISDICTION 1 2 ECF No. 17 The Court has jurisdiction over this case pursuant to 42 U.S.C. §§ 405(g), 1383(c)(3). STANDARD OF REVIEW A district court’s review of a final decision of the Commissioner of Social 6 Security is governed by 42 U.S.C. § 405(g). The scope of review under § 405(g) is 7 limited: the Commissioner’s decision will be disturbed “only if it is not supported 8 by substantial evidence or is based on legal error.” Hill v. Astrue, 698 F.3d 1153, 9 1158-59 (9th Cir. 2012) (citing 42 U.S.C. § 405(g)). “Substantial evidence” means 10 relevant evidence that “a reasonable mind might accept as adequate to support a 11 conclusion.” Id. at 1159 (quotation and citation omitted). Stated differently, 12 substantial evidence equates to “more than a mere scintilla[,] but less than a 13 preponderance.” Id. (quotation and citation omitted). In determining whether this 14 standard has been satisfied, a reviewing court must consider the entire record as a 15 whole rather than searching for supporting evidence in isolation. Id. 16 In reviewing a denial of benefits, a district court may not substitute its 17 judgment for that of the Commissioner. Edlund v. Massanari, 253 F.3d 1152, 18 1156 (9th Cir. 2001). If the evidence in the record “is susceptible to more than one 19 rational interpretation, [the Court] must uphold the ALJ’s findings if they are 20 supported by inferences reasonably drawn from the record.” Molina v. Astrue, 674 ORDER DENYING PLAINTIFF’S MOTION FOR SUMMARY JUDGMENT AND GRANTING DEFENDANT’S MOTION FOR SUMMARY JUDGMENT ~ 2 Case 1:22-cv-03065-TOR ECF No. 17 filed 12/20/22 PageID.512 Page 3 of 15 1 F.3d 1104, 1111 (9th Cir. 2012). Further, a district court “may not reverse an 2 ALJ’s decision on account of an error that is harmless.” Id. An error is harmless 3 “where it is inconsequential to the [ALJ’s] ultimate nondisability determination.” 4 Id. at 1115 (quotation and citation omitted). The party appealing the ALJ’s 5 decision generally bears the burden of establishing that it was harmed. Shinseki v. 6 Sanders, 556 U.S. 396, 409-10 (2009). 7 8 9 FIVE STEP SEQUENTIAL EVALUATION PROCESS A claimant must satisfy two conditions to be considered “disabled” within the meaning of the Social Security Act. First, the claimant must be unable “to 10 engage in any substantial gainful activity by reason of any medically determinable 11 physical or mental impairment which can be expected to result in death or which 12 has lasted or can be expected to last for a continuous period of not less than 12 13 months.” 42 U.S.C. §§ 423(d)(1)(A), 1382c(a)(3)(A). Second, the claimant’s 14 impairment must be “of such severity that [he or she] is not only unable to do [his 15 or her] previous work[,] but cannot, considering [his or her] age, education, and 16 work experience, engage in any other kind of substantial gainful work which exists 17 in the national economy.” 42 U.S.C. §§ 423(d)(2)(A), 1382c(a)(3)(B). 18 The Commissioner has established a five-step sequential analysis to 19 determine whether a claimant satisfies the above criteria. See 20 C.F.R. § 20 416.920(a)(4)(i)-(v). At step one, the Commissioner considers the claimant’s work ORDER DENYING PLAINTIFF’S MOTION FOR SUMMARY JUDGMENT AND GRANTING DEFENDANT’S MOTION FOR SUMMARY JUDGMENT ~ 3 Case 1:22-cv-03065-TOR ECF No. 17 filed 12/20/22 PageID.513 Page 4 of 15 1 activity. 20 C.F.R. § 416.920(a)(4)(i). If the claimant is engaged in “substantial 2 gainful activity,” the Commissioner must find that the claimant is not disabled. 20 3 C.F.R. § 416.920(b). 4 If the claimant is not engaged in substantial gainful activities, the analysis 5 proceeds to step two. At this step, the Commissioner considers the severity of the 6 claimant’s impairment. 20 C.F.R. § 416.920(a)(4)(ii). If the claimant suffers from 7 “any impairment or combination of impairments which significantly limits [his or 8 her] physical or mental ability to do basic work activities,” the analysis proceeds to 9 step three. 20 C.F.R. § 416.920(c). If the claimant’s impairment does not satisfy 10 this severity threshold, however, the Commissioner must find that the claimant is 11 not disabled. Id. 12 At step three, the Commissioner compares the claimant’s impairment to 13 several impairments recognized by the Commissioner to be so severe as to 14 preclude a person from engaging in substantial gainful activity. 20 C.F.R. § 15 416.920(a)(4)(iii). If the impairment is as severe or more severe than one of the 16 enumerated impairments, the Commissioner must find the claimant disabled and 17 award benefits. 20 C.F.R. § 416.920(d). 18 If the severity of the claimant’s impairment does meet or exceed the severity 19 of the enumerated impairments, the Commissioner must pause to assess the 20 claimant’s “residual functional capacity.” Residual functional capacity (“RFC”), ORDER DENYING PLAINTIFF’S MOTION FOR SUMMARY JUDGMENT AND GRANTING DEFENDANT’S MOTION FOR SUMMARY JUDGMENT ~ 4 Case 1:22-cv-03065-TOR ECF No. 17 filed 12/20/22 PageID.514 Page 5 of 15 1 defined generally as the claimant’s ability to perform physical and mental work 2 activities on a sustained basis despite his or her limitations (20 C.F.R. § 3 416.945(a)(1)), is relevant to both the fourth and fifth steps of the analysis. 4 At step four, the Commissioner considers whether, in view of the claimant’s 5 RFC, the claimant is capable of performing work that he or she has performed in 6 the past (“past relevant work”). 20 C.F.R. § 416.920(a)(4)(iv). If the claimant is 7 capable of performing past relevant work, the Commissioner must find that the 8 claimant is not disabled. 20 C.F.R. § 416.920(f). If the claimant is incapable of 9 performing such work, the analysis proceeds to step five. 10 At step five, the Commissioner considers whether, in view of the claimant’s 11 RFC, the claimant is capable of performing other work in the national economy. 12 20 C.F.R. § 416.920(a)(4)(v). In making this determination, the Commissioner 13 must also consider vocational factors such as the claimant’s age, education and 14 work experience. Id. If the claimant is capable of adjusting to other work, the 15 Commissioner must find that the claimant is not disabled. 20 C.F.R. § 16 416.920(g)(1). If the claimant is not capable of adjusting to other work, the 17 analysis concludes with a finding that the claimant is disabled and is therefore 18 entitled to benefits. Id. 19 20 The claimant bears the burden of proof at steps one through four above. Tackett v. Apfel, 180 F.3d 1094, 1098 (9th Cir. 1999). If the analysis proceeds to ORDER DENYING PLAINTIFF’S MOTION FOR SUMMARY JUDGMENT AND GRANTING DEFENDANT’S MOTION FOR SUMMARY JUDGMENT ~ 5 Case 1:22-cv-03065-TOR ECF No. 17 filed 12/20/22 PageID.515 Page 6 of 15 1 step five, the burden shifts to the Commissioner to establish that (1) the claimant is 2 capable of performing other work; and (2) such work “exists in significant 3 numbers in the national economy.” 20 C.F.R. § 416.960(c)(2); Beltran v. Astrue, 4 700 F.3d 386, 389 (9th Cir. 2012). 5 6 ALJ’S FINDINGS On October 10, 2019, Claimant protectively filed an application for Title 7 XVI supplemental security income benefits, alleging a disability onset date of 8 October 1, 2019. Tr. 15. The application was denied initially, Tr. 50-59, and on 9 reconsideration, Tr. 60-70. Claimant appeared at a telephonic hearing before an 10 administrative law judge (“ALJ”) on May 19, 2021. Tr. 28-49. On May 26, 2021, 11 the ALJ denied Plaintiff’s claim. Tr. 15-23. 12 At step one of the sequential evaluation analysis, the ALJ found Claimant 13 had not engaged in substantial gainful activity since October 10, 2019, the 14 application date. Tr. 17. At step two, the ALJ found Claimant had the following 15 severe impairments: depressive disorder, posttraumatic stress disorder (PTSD), and 16 polysubstance dependence. Id. At step three, the ALJ found that Claimant’s 17 impairments did not meet or medically equal the severity of a listed impairment. 18 Tr. 17-18. The ALJ then found that Claimant had the RFC to perform a full range 19 of work at all exertional levels but with the following nonexertional limitations: 20 [S]he can understand, remember and carry out simple instructions and exercise simple workplace judgment; she can perform work ORDER DENYING PLAINTIFF’S MOTION FOR SUMMARY JUDGMENT AND GRANTING DEFENDANT’S MOTION FOR SUMMARY JUDGMENT ~ 6 Case 1:22-cv-03065-TOR 1 2 3 4 ECF No. 17 filed 12/20/22 PageID.516 Page 7 of 15 that is learned by on the job training beyond a short demonstration lasting up to and including one month; she can respond appropriately to supervision but should not be required to work in close coordination with coworkers where teamwork is required; she can deal with occasional changes in the work environment; and she can work in jobs that require no interaction with the public to perform work tasks but does not preclude working environment where the public is present. 5 6 Tr. 19. 7 At step four, the ALJ found that Claimant had no past relevant work. Tr. 22. 8 At step five, the ALJ found, based on Claimant’s age, education, work experience, 9 and residual functional capacity, there were jobs that existed in significant numbers 10 in the national economy that Claimant could perform, such as industrial cleaner, 11 vehicle cleaner, and salvage laborer. Tr. 22-23. The ALJ concluded Claimant was 12 not under a disability, as defined in the Social Security Act, from October 10, 2019 13 through May 26, 2021, the date of the ALJ’s decision. Tr. 23. 14 On March 18, 2022, the Appeals Council denied review, Tr. 1-3, making the 15 ALJ’s decision the Commissioner’s final decision for purposes of judicial review. 16 See 42 U.S.C. § 1383(c)(3). 17 18 ISSUES Claimant seeks judicial review of the Commissioner’s final decision denying 19 him supplemental security income benefits under Title XVI of the Social Security 20 Act. Claimant raises the following issues for this Court’s review: ORDER DENYING PLAINTIFF’S MOTION FOR SUMMARY JUDGMENT AND GRANTING DEFENDANT’S MOTION FOR SUMMARY JUDGMENT ~ 7 Case 1:22-cv-03065-TOR ECF No. 17 filed 12/20/22 PageID.517 Page 8 of 15 1. Whether the ALJ reversibly erred by improperly rejecting Claimant’s 1 2 symptom testimony for reasons that were not clear and convincing; and 3 2. Whether the ALJ reversibly erred by improperly evaluating the medical 4 5 opinion evidence. ECF No. 11 at 2. DISCUSSION 6 7 A. Subjective Symptom Testimony 8 Claimant contends the ALJ failed to rely on clear and convincing reasons to 9 10 11 discredit Claimant’s subjective symptom testimony. ECF Nos. 11 at 4–10; 15 at 2–4. An ALJ engages in a two-step analysis to determine whether to discount a 12 claimant’s testimony regarding subjective symptoms. SSR 16-3p, 2016 WL 13 1119029, at *2. “First, the ALJ must determine whether there is ‘objective 14 medical evidence of an underlying impairment which could reasonably be 15 expected to produce the pain or other symptoms alleged.’” Molina, 674 F.3d at 16 1112 (quoting Vasquez v. Astrue, 572 F.3d 586, 591 (9th Cir. 2009)). “The 17 claimant is not required to show that [the claimant’s] impairment ‘could reasonably 18 be expected to cause the severity of the symptom [the claimant] has alleged; [the 19 claimant] need only show that it could reasonably have caused some degree of the 20 symptom.’” Vasquez, 572 F.3d at 591 (quoting Lingenfelter v. Astrue, 504 F.3d ORDER DENYING PLAINTIFF’S MOTION FOR SUMMARY JUDGMENT AND GRANTING DEFENDANT’S MOTION FOR SUMMARY JUDGMENT ~ 8 Case 1:22-cv-03065-TOR 1 2 ECF No. 17 filed 12/20/22 PageID.518 Page 9 of 15 1028, 1035–36 (9th Cir. 2007)). Second, “[i]f the claimant meets the first test and there is no evidence of 3 malingering, the ALJ can only reject the claimant’s testimony about the severity of 4 the symptoms if [the ALJ] gives ‘specific, clear and convincing reasons’ for the 5 rejection.” Ghanim v. Colvin, 763 F.3d 1154, 1163 (9th Cir. 2014) (citations 6 omitted). General findings are insufficient; rather, the ALJ must identify what 7 symptom claims are being discounted and what evidence undermines these claims. 8 Id. (quoting Lester v. Chater, 81 F.3d 821, 834 (9th Cir. 1995)); Thomas v. 9 Barnhart, 278 F.3d 947, 958 (9th Cir. 2002) (requiring the ALJ to sufficiently 10 explain why he or she discounted claimant’s symptom claims). “The clear and 11 convincing [evidence] standard is the most demanding required in Social Security 12 cases.” Garrison v. Colvin, 759 F.3d 995, 1015 (9th Cir. 2014) (quoting Moore v. 13 Comm’r of Soc. Sec. Admin., 278 F.3d 920, 924 (9th Cir. 2002)). 14 Factors to be considered in evaluating the intensity, persistence, and limiting 15 effects of a claimant’s symptoms include: (1) daily activities; (2) the location, 16 duration, frequency, and intensity of pain or other symptoms; (3) factors that 17 precipitate and aggravate the symptoms; (4) the type, dosage, effectiveness, and 18 side effects of any medication an individual takes or has taken to alleviate pain or 19 other symptoms; (5) treatment, other than medication, an individual receives or has 20 received for relief of pain or other symptoms; (6) any measures other than ORDER DENYING PLAINTIFF’S MOTION FOR SUMMARY JUDGMENT AND GRANTING DEFENDANT’S MOTION FOR SUMMARY JUDGMENT ~ 9 Case 1:22-cv-03065-TOR ECF No. 17 filed 12/20/22 PageID.519 Page 10 of 15 1 treatment an individual uses or has used to relieve pain or other symptoms; and (7) 2 any other factors concerning an individual’s functional limitations and restrictions 3 due to pain or other symptoms. SSR 16-3p, 2016 WL 1119029, at *7–8; 20 C.F.R. 4 § 404.1529(c). The ALJ is instructed to “consider all of the evidence in an 5 individual’s record,” “to determine how symptoms limit ability to perform work- 6 related activities.” SSR 16-3p, 2016 WL 1119029, at *2. 7 The ALJ found Claimant’s medically determinable impairments could 8 reasonably be expected to cause some of the alleged symptoms; however, 9 Claimant’s statements concerning the intensity, persistence, and limiting effects of 10 those symptoms were not entirely consistent with the medical evidence and other 11 evidence in the record. Tr. 19. In arriving at this conclusion, the ALJ considered 12 several of the factors described above. 13 The ALJ found that Claimant’s mental health complaints were out of 14 proportion to the objective medical evidence. Tr. 20. Claimant contradicted 15 herself when and whether she was using methamphetamine and marijuana. Id. 16 She reported auditory hallucinations, yet was attentive and completely oriented on 17 exam. Id. In September 2020, she reported smoking THC yet had a euthymic 18 mood and full affect, logical thought, within normal limit of cognition, displayed 19 average intelligence, and had normal insight and judgment. Id. Despite allegations 20 of disabling depression and PTSD related symptoms, Claimant was not fully ORDER DENYING PLAINTIFF’S MOTION FOR SUMMARY JUDGMENT AND GRANTING DEFENDANT’S MOTION FOR SUMMARY JUDGMENT ~ 10 Case 1:22-cv-03065-TOR ECF No. 17 filed 12/20/22 PageID.520 Page 11 of 15 1 compliant with her treatment. Tr. 20-21. While Claimant has issues with 2 substance abuse and medication compliance, she shows appropriate / normal mood 3 and within normal limit cognition. Tr. 21. The ALJ also noted that there is a 4 situational component to Claimant’s mental condition, rather than due solely to her 5 medically determinable impairments. Tr. 21. 6 The Court finds the ALJ provided clear and convincing reasons supported by 7 substantial evidence in the record to discount Claimant’s subjective symptom 8 testimony. 9 10 11 B. Medical Opinion Evidence Claimant challenges the ALJ’s evaluation of Thomas Genthe, Ph.D.’s medical opinion. Tr. 11 at 10-20. 12 As an initial matter, for claims filed on or after March 27, 2017, new 13 regulations apply that change the framework for how an ALJ must evaluate 14 medical opinion evidence. 20 C.F.R. § 416.920c(c); see also Revisions to Rules 15 Regarding the Evaluation of Medical Evidence, 2017 WL 168819, 82 Fed. Reg. 16 5844-01 (Jan. 18, 2017). The ALJ applied the new regulations because Plaintiff 17 filed her Title XVI claim after March 27, 2017. 18 Under the new regulations, the ALJ will no longer “give any specific 19 evidentiary weight … to any medical opinion(s).” Revisions to Rules, 2017 WL 20 168819, 82 Fed. Reg. 5844-01, 5867-68. Instead, an ALJ must consider and ORDER DENYING PLAINTIFF’S MOTION FOR SUMMARY JUDGMENT AND GRANTING DEFENDANT’S MOTION FOR SUMMARY JUDGMENT ~ 11 Case 1:22-cv-03065-TOR ECF No. 17 filed 12/20/22 PageID.521 Page 12 of 15 1 evaluate the persuasiveness of all medical opinions or prior administrative medical 2 findings from medical sources. 20 C.F.R. § 416.920c(a)-(b). The factors for 3 evaluating the persuasiveness of medical opinions and prior administrative medical 4 findings include supportability, consistency, relationship with the claimant, 5 specialization, and “other factors that tend to support or contradict a medical 6 opinion or prior administrative medical finding” including but not limited to 7 “evidence showing a medical source has familiarity with the other evidence in the 8 claim or an understanding of our disability program’s policies and evidentiary 9 requirements.” 20 C.F.R. § 416.920c(c)(1)-(5). 10 The ALJ is required to explain how the most important factors, 11 supportability and consistency, were considered. 20 C.F.R. § 416.920c(b)(2). 12 These factors are explained as follows: 13 14 15 16 17 (1) Supportability. The more relevant the objective 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. (2) Consistency. The 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. 18 19 20 C.F.R. § 416.920c(c)(1)-(2). 20 ORDER DENYING PLAINTIFF’S MOTION FOR SUMMARY JUDGMENT AND GRANTING DEFENDANT’S MOTION FOR SUMMARY JUDGMENT ~ 12 Case 1:22-cv-03065-TOR 1 ECF No. 17 filed 12/20/22 PageID.522 Page 13 of 15 The ALJ may, but is not required to, explain how “the other most persuasive 2 factors in paragraphs (c)(3) through (c)(5)” were considered. 20 C.F.R. 3 § 416.920c(c)(b)(2). However, where two or more medical opinions or prior 4 administrative findings “about the same issue are both equally well-supported … 5 and consistent with the record … but are not exactly the same,” the ALJ is required 6 to explain how “the most persuasive factors” were considered. 20 C.F.R. 7 § 416.920c(c)(b)(2). 8 These regulations displace the Ninth Circuit’s standard that require an ALJ 9 to provide “specific and legitimate” reasons for rejecting an examining doctor’s 10 opinion. Woods v. Kijakazi, 32 F.4th 785, 787 (9th Cir. 2022). As a result, the 11 ALJ’s decision for discrediting any medical opinion “must simply be supported by 12 substantial evidence.” Id. 13 Dr. Genthe assessed Claimant with marked to severe impairment in several 14 areas of functioning. Tr. 286-87. The ALJ found this assessment neither well 15 supported nor consistent with the record. Tr. 21. The ALJ also noted that Dr. 16 Genthe reviewed no records. Tr. 21. As a result, Dr. Genthe did not have full 17 knowledge of the longitudinal record. Id. The ALJ pointed out the contradictions 18 in methamphetamine use reported to Dr. Genthe and at other places in the record. 19 Tr. 21-22. Dr. Genthe claimed deficits in cognitive functioning on exam which 20 contradicted her performance on mental status exams throughout the record which ORDER DENYING PLAINTIFF’S MOTION FOR SUMMARY JUDGMENT AND GRANTING DEFENDANT’S MOTION FOR SUMMARY JUDGMENT ~ 13 Case 1:22-cv-03065-TOR ECF No. 17 filed 12/20/22 PageID.523 Page 14 of 15 1 primarily showed within normal limit cognition. Tr. 22. Dr. Genthe also assessed 2 marked to severe limitations in several areas of functioning which was inconsistent 3 with the record that showed improvement in symptoms with medication. Id. 4 Finally, Dr. Genthe’s opinion was inconsistent with claimant’s activities including 5 the ability to tend to her personal care, perform a variety of chores, use public 6 transportation, and care for her dog including seeking care for it at a veterinarian 7 when needed. Id. 8 9 Moreover, the ALJ used Renee Eisenhauer, PhD and Michael Brown, PhD’s opinions. Tr. 22. They both reviewed the record and their opinion is consistent 10 with the medical evidence. Id. The record showed improvement in mental health 11 symptoms with medication, that claimant consistently displayed intact cognition on 12 mental status exams regardless of substance use, claimant endorsed some problems 13 with social functioning, but she attended appointments independently and 14 interacted appropriately with providers. Id. Claimant’s mental status exams 15 showed the Claimant as cooperative. Id. Claimant uses public transportation. Id. 16 Finally, the ALJ compensated for the Claimant’s cognitive and social limitations in 17 the residual functional capacity assessment. 18 CONCLUSION 19 Having reviewed the record and the ALJ’s findings, the Court concludes the 20 ALJ’s decision is supported by substantial evidence and free of harmful legal error. ORDER DENYING PLAINTIFF’S MOTION FOR SUMMARY JUDGMENT AND GRANTING DEFENDANT’S MOTION FOR SUMMARY JUDGMENT ~ 14 Case 1:22-cv-03065-TOR 1 ECF No. 17 filed 12/20/22 PageID.524 Page 15 of 15 ACCORDINGLY, IT IS HEREBY ORDERED: 2 1. Plaintiff’s Motion for Summary Judgment (ECF No. 11) is DENIED. 3 2. Defendant’s Motion for Summary Judgment (ECF No. 12) is 4 5 6 7 GRANTED. The District Court Executive is directed to enter this Order, enter judgment accordingly, furnish copies to counsel, and CLOSE the file. DATED December 20, 2022. 8 9 THOMAS O. RICE United States District Judge 10 11 12 13 14 15 16 17 18 19 20 ORDER DENYING PLAINTIFF’S MOTION FOR SUMMARY JUDGMENT AND GRANTING DEFENDANT’S MOTION FOR SUMMARY JUDGMENT ~ 15
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