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WO 

IN THE UNITED STATES DISTRICT COURT 

FOR THE DISTRICT OF ARIZONA 

Jerome Wayne Wringer, 

Plaintiff, 

v. 

Carolyn W Colvin, 

Defendant. 

No. CV-15-02554-PHX-DLR

ORDER 

 Plaintiff Jerome Wringer seeks review under 42 U.S.C. § 405(g) of the final 

decision of the Commissioner of Social Security (Commissioner) denying his application 

for supplemental security income and disability insurance benefits. Because the decision 

of the Administrative Law Judge (ALJ) is supported by substantial evidence and is not 

based on legal error, the Commissioner’s decision is affirmed. 

I. Background 

 A. Factual Background 

 Wringer is 67 years old and has an eleventh grade education. (A.R. 18.) He last 

worked as an automobile service manager. (Doc. 12 at 1.) The business closed in 2008, 

and he has not worked since that time. (A.R. 21.) Wringer reported looking for work in 

March 2012, immediately before he applied for benefits. (Id. at 761.) He alleges 

disability due to chronic back pain, nerve damage, hernia, irregular heartbeat, left eye 

blindness, sleep apnea, and anxiety. (Id. at 18.) 

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B. Procedural History 

 On March 16, 2012, Wringer applied for disability insurance benefits and 

supplemental security income, alleging disability beginning March 1, 2008. (Id. at 11.) 

On May 14, 2014, he appeared with his attorney and testified at a hearing before the ALJ. 

A vocational expert also testified. 

 On July 25, 2014, the ALJ issued a decision that Wringer was not disabled within 

the meaning of the Social Security Act. The Appeals Counsel denied Wringer’s request 

for review of the hearing decision, making the ALJ’s decision the Commissioner’s final 

decision. On December 16, 2015, Wringer sought review by this Court. 

II. Legal Standard 

 The district court reviews only those issues raised by the party challenging the 

ALJ’s 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 the determination 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, less than a 

preponderance, and relevant evidence that a reasonable person might accept as adequate 

to support a conclusion considering the record as a whole. Id. In determining whether 

substantial evidence supports a decision, the court must consider the record as a whole 

and may not affirm simply by isolating a “specific quantum of supporting evidence.” Id. 

As a general rule, “[w]here 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) (citations omitted). 

III. Five-Step Sequential Evaluation Process 

To determine whether a claimant is disabled for purposes of the Social Security 

Act, the ALJ follows a five-step process. 20 C.F.R. § 404.1520(a). The claimant bears 

the burden of proof on the first four steps, but at step five, the burden shifts to the 

Commissioner. Tackett v. Apfel, 180 F.3d 1094, 1098 (9th Cir. 1999). 

 At the first step, the ALJ determines whether the claimant is engaging in 

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substantial gainful activity. 20 C.F.R. § 404.1520(a)(4)(i). If so, the claimant is not 

disabled and the inquiry ends. Id. At step two, the ALJ determines whether the claimant 

has a “severe” medically determinable physical or mental impairment. 

§ 404.1520(a)(4)(ii). If not, the claimant is not disabled and the inquiry ends. Id. At step 

three, the ALJ considers whether the claimant’s impairment or combination of 

impairments meets or medically equals an impairment listed in Appendix 1 to Subpart P 

of 20 C.F.R. Pt. 404. § 404.1520(a)(4)(iii). If so, the claimant is automatically found to 

be disabled. Id. If not, the ALJ proceeds to step four. At step four, the ALJ assesses the 

claimant’s residual functional capacity (RFC) and determines whether the claimant is still 

capable of performing past relevant work. § 404.1520(a)(4)(iv). If so, the claimant is not 

disabled and the inquiry ends. Id. If not, the ALJ proceeds to the fifth and final step, 

where he determines whether the claimant can perform any other work based on the 

claimant’s RFC, age, education, and work experience. § 404.1520(a)(4)(v). If so, the 

claimant is not disabled. Id. If not, the claimant is disabled. Id.

At step one, the ALJ found that Wringer meets the insured status requirements of 

the Social Security Act through December 31, 2013, and that he has not engaged in 

substantial gainful activity since August 12, 2008. (A.R. 13.) At step two, the ALJ found 

that Wringer has the following severe impairments: left ear decreased hearing, blindness 

in left eye, depression, mild cognitive impairment, and anxiety. (Id.) At step three, the 

ALJ determined that Wringer does not have an impairment or combination of 

impairments that meets or medically equals an impairment listed in Appendix 1 to 

Subpart P of 20 C.F.R. Pt. 404. (Id. at 15.) 

 At step four, the ALJ found that Wringer has the RFC to perform: 

medium work as defined in 20 C.F.R. § 404.1567(c) with the following 

additional limitations: frequently climb, balance, stoop, crouch, kneel and 

crawl; has to avoid concentrated exposure to excessive, loud noise; needs 

work that is simple, routine and repetitive; work with only occasional 

interaction with public, coworkers and supervisors but he can still be in 

vicinity of others; limited depth perception due to monocular vision. 

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(Id. at 17.) At step five, the ALJ concluded that, considering Wringer’s age, education, 

work experience, and residual functional capacity, there are jobs that exist in significant 

numbers in the national economy that he could perform. (Id. at 22.) 

IV. Analysis 

 Wringer argues the ALJ’s decision should be overturned because (1) the ALJ 

improperly discounted the testimony of treating physician Dr. Robert Rosenberg, and (2) 

the RFC is not supported by substantial evidence. (Doc. 12 at 4, 13.) The Court will 

address each argument in turn. 

A. The ALJ Did Not Err in Evaluating Medical Opinion Evidence 

 The ALJ is responsible for resolving conflicts in medical testimony. Andrews v. 

Shalala, 53 F.3d 1035, 1039 (9th Cir. 1995). Generally, more weight should be given to 

the opinion of a treating physician than to the opinions of non-treating physicians. Lester 

v. Chater, 81 F.3d 821, 830 (9th Cir. 1995). Where a treating physician’s opinion is not 

contradicted by another physician, it may be rejected only for “clear and convincing” 

reasons, and where it is contradicted, it may not be rejected without “specific and 

legitimate reasons” supported by substantial evidence in the record. Id. Likewise, an 

examining physician’s opinion generally must be given greater weight than that of a nonexamining physician. Id. at 830. As with a treating physician, there must be clear and 

convincing reasons for rejecting the uncontradicted opinion of an examining physician, 

and specific and legitimate reasons, supported by substantial evidence in the record, for 

rejecting an examining physician’s contradicted opinion. Id. at 830-31. 

 Dr. Rosenberg treated Wringer for approximately four years. On July 13, 2013, he 

submitted a check-box style medical source statement regarding Wringer’s symptoms. 

(A.R. 463-66.) He opined that Wringer could sit, stand or walk for 0-2 hours in an eighthour workday. (Id. at 464.) Wringer could rarely lift and carry less than 10 pounds and 

never carry lift and carry twenty pounds. (Id.) Dr. Rosenberg opined that Wringer has 

significant limitations in doing repetitive reaching, handling, fingering or lifting and 

would be unable to keep his neck in a constant position. (Id.) In addition, Dr. 

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Rosenberg opined that Wringer was not able to work full time, that emotional factors 

contributed to the severity of Wringer’s symptoms, that Wringer was only capable of low 

stress work, and that he would miss more than three days of work per month. (Id. at 465-

66.) He also found Wringer is unable to stoop, push, pull, and kneel. (Id. at 465.) Dr. 

Rosenberg stated that the basis for his opinion is “patient’s response to these questions 

[and] interview—plus seeing the patient in my office monthly for the past 4 years[.]” 

(Id.) 

 Dr. Rosenberg’s opinion was contradicted by the opinions of Dr. John Vorhies and 

Dr. Kenneth Glass. Both non-examining physicians opined that Wringer could sit, stand 

or walk for 6 hours in an eight-hour workday; lift and carry 50 pounds occasionally; lift 

and carry 25 pounds frequently; and was unlimited in his ability to push and pull. (Id. at 

67, 83.) In addition, both physicians found that Wringer could frequently climb ramps 

and stairs; climb ladders, ropes, and scaffolds, balance, stoop, kneel, crouch, and crawl. 

(Id. at 68, 83.) Therefore, the ALJ was required to provide specific and legitimate 

reasons supported by substantial evidence for discounting Dr. Rosenberg’s opinion. See 

Lester, 81 F.3d at 830.1

 The ALJ gave reduced weight to Dr. Rosenberg’s opinion because it was a “form 

consisting largely of checked boxes without further explanation” and the extreme 

findings “contrast sharply” with the other record medical evidence, including Dr. 

Rosenberg’s own treatment notes. (A.R. 19.) The form contains 25 questions, only one 

of which calls for Dr. Rosenberg’s conclusions regarding his findings. (Id. at 465.) 

Therein, Dr. Rosenberg explained that his findings were based on Wringer’s answers to 

the questions, as well as past visits. (Id.) The form, however, contains no clinical 

 

1

 Wringer argues the clear and convincing reasons standard applies because Dr. Rosenberg’s opinion was uncontradicted by another “examining source”—neither Dr. Vorheis nor Dr. Glass examined Wringer. (Doc. 12 at 7.) But Wringer cites no authority for the proposition that a treating physician opinion may be contradicted only by another examining source. A non-examining physician’s contradictory opinion triggers the specific and legitimate reasons standard. See Lester, 81 F.3d at 830 (“if the treating doctor’s opinion is contradicted by another doctor, the Commissioner may not reject this opinion without providing ‘specific and legitimate reasons’ supported by substantial evidence”) (emphasis added). 

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evidence and cites to no prior treatment notes or medical diagnoses. Instead, it appears to 

be based largely on Wringer’s subjective complaints. It is proper for an ALJ to reject 

medical opinion testimony that consists of a check-off report unsupported by explanation. 

See Crane v. Shalala, 76 F.3d 251, 253 (9th Cir. 1996) (finding the ALJ “permissibly 

rejected [three psychological evaluations] because they were check-off reports that did 

not contain any explanation of the bases of their conclusions”).2

 Furthermore, the record does not support such extreme findings. Both Dr. Vorhies 

and Dr. Glass found far greater functional abilities than Dr. Rosenberg. In addition, one 

month after Dr. Rosenberg completed the assessment form, his treatment notes indicate 

that Wringer had normal muscle strength and tone, normal gait, and normal muscle 

appearance. (Id. at 743.) In fact, there were no remarkable physical findings. (Id.) 

Further, the record consistently indicates normal physical findings, including no joint or 

muscle tenderness, normal muscle strength, and normal range of motion in the 

extremities. (See, e.g., id. at 264 (noting “[f]ull range of motion of all 4 extremities. No 

joint or muscle tenderness.”); 637 (noting “[j]oints are intact and stable,” “normal gait,” 

“[n]o midline back tenderness”); 654-55 (noting normal extremities and normal MRI); 

665 (“the thoracolumbar spine had a normal appearance, normal gait and muscle strength 

and tone were normal”); 700 (noting unremarkable physical findings)). Nonetheless, Dr. 

Rosenberg concluded that Wringer was incapable of standing or sitting more than two 

hours in a workday; that he could not push, pull stoop, kneel, finger, reach, handle or 

keep his neck in a constant position; and that he could never lift or carry 20 pounds. The 

evidence does not support this assessment, and Wringer fails to cite to one treatment note 

that supports Dr. Rosenberg’s physical findings. The Court agrees with the ALJ that the 

 

2

 Wringer asserts the form contains several narrative sections where Dr. Rosenberg described Wringer’s medical condition. (Doc. 12 at 10.) But the sections cite no medical 

evidence—Dr. Rosenberg merely cites conclusory diagnoses. Wringer also argues that Dr. Vorheis and Dr. Glass used similar forms. (Id.) Indeed, the forms are in the checkbox style. Both, however, contain numerous citations to record medical evidence, 

evidence summaries, and refer to Dr. Rosenberg’s own treatment notes. Moreover, both 

physicians provided adequate explanation for their findings. 

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evidence is wholly inconsistent with Dr. Rosenberg’s extreme findings.3 

 Accordingly, the Court finds the ALJ set forth specific and legitimate reasons 

supported by substantial evidence for discounting Dr. Rosenberg’s opinion. See Lester, 

81 F.3d at 830. 

B. The ALJ Did Not Err in Formulating the RFC 

 Wringer argues the RFC fails to account for his mental limitations. (Doc. 12 at 

14.) He claims the ALJ failed to fully incorporate the cognitive findings of the state 

agency reviewing psychologists and Dr. Amy Knapp, examining psychologist. (Id.) The 

Court disagrees. 

 The ALJ found that Wringer had the mental capacity to perform “work that is 

simple, routine and repetitive; [and] work with only occasional interaction with public, 

coworkers and supervisors but he can still be in vicinity of others.” (A.R. 17.) This 

formulation is consistent with the evidence. On October 25, 2012, state agency 

reviewing physician Dr. Diane Kogut concluded that Wringer was not significantly 

limited in his ability to carry out very short and simple instructions, work in coordination 

with or in proximity to others, and make simple work-related decisions. (Id. at 69.) She 

also noted that Wringer was moderately limited in his ability to carry out detailed 

instructions, maintain concentration and attention for extended periods, and sustain an 

ordinary routine without special supervision. (Id.) As such, she concluded Wringer 

could perform “work where interpersonal contact is incidental to work performed, e.g. 

assembly work; complexity of tasks is learned and performed by rote, few variables, little 

judgment; supervision required is simple, direct and concrete.” (Id. at 70.) Similarly, in 

May 2013, another state agency reviewing physician concluded that Wringer could 

perform the same type of work. (Id. at 81.) 

 On April 30, 2014, Wringer underwent a neuropsychological evaluation with Dr. 

 

3

 Wringer points to his hernia surgeries, vascular compromise in the left testicle, and abdominal cramping as evidence in support of Dr. Rosenberg’s conclusions. (Doc. 14 at 4.) But these medical conditions occurred in 2007 and 2008, (see id.), and there is 

no evidence that they later affected Wringer’s physical functional abilities. 

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Amy Knapp. (Id. at 1934-40.) Dr. Knapp concluded that tests revealed Wringer had 

“intact cognitive functioning for his age and education in the areas of overall mental 

status, reading skills, verbal comprehension, perceptual reasoning, auditory working 

memory, attention, visuomotor processing, visuocontruction ability, and language.” (Id.

at 1937.) In addition, “[s]ignificant and profound cognitive impairment was found in the 

areas of visual memory and verbal recognition ability.” (Id.) Consequently, Dr. Knapp 

concluded that Wringer suffered from “mild cognitive impairment,” but that “[f]urther 

monitoring of his cognitive disruption is needed to better determine whether his cognitive 

decline is related to a neurological or medical condition, or is better accounted for by his 

significant anxiety and other mental health concerns.” (Id. at 1937-38.) She 

recommended Wringer adhere to a regimen of physical exercise and mind stimulating 

activities, such as crossword puzzles. (Id. at 1939.) 

 “[T]he ALJ is the final arbiter with respect to resolving ambiguities in the medical 

evidence,” Tommasetti v. Astrue, 533 F.3d 1035, 1041 (9th Cir. 2008), and there is no 

requirement that the RFC mirror any specific medical opinion, 20 C.F.R. § 404.945(a). 

Furthermore, “[w]here the evidence is susceptible to more than one rational 

interpretation, it is the ALJ’s conclusion that must be upheld.” Morgan v. Comm’r of 

Soc. Sec. Admin., 169 F.3d 595, 599 (9th Cir. 1999). 

 Here, the Court finds the ALJ’s interpretation of the medical evidence is 

reasonable, and thus the RFC is supported by substantial evidence in the record. 

Notwithstanding his cognitive limitations, both state agency reviewing physicians found 

Wringer capable of simple, routine work with little interpersonal contact. Dr. Knapp’s 

conclusions support this finding, and the ALJ accounted for Wringer’s mental limitations 

in the RFC, including the limitation that Wringer be limited to occasional contact with 

other people. Other than Dr. Rosenberg’s medical opinion, to which the ALJ assessed 

reduced weight, there is no evidence suggesting Wringer cannot follow simple 

instructions, perform routine and repetitive work, and occasionally act with other people. 

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Accordingly, the Court will not disturb the ALJ’s decision.4 

IT IS ORDERED that the final decision of the Commissioner of Social Security 

is AFFIRMED. The Clerk shall enter judgment accordingly and terminate this case. 

 Dated this 27th day of July, 2016. 

Douglas L. Rayes 

United States District Judge 

 

4

 Wringer argues that the RFC fails to account for Dr. Kogut’s conclusion that Wringer be limited to “simple, direct and concrete supervision.” (Dc. 12 at 16.) But the 

RFC limits Wringer to simple work with occasional contact with supervisions. It can be inferred that simple work only requires simple and concrete supervision to perform. This argument is unpersuasive. 

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