JOHN R. TUNHEIM, District Judge.
The Commissioner of Social Security ("the Commissioner")
The facts of this case have been extensively summarized in the R&R (R&R at 2-12) and in previous orders, see Kirchner v. Astrue, Civ. No. 10-3263, 2011 WL 2555385 (D. Minn. June 2, 2011) report and recommendation adopted in part, rejected in part, Civ. No. 10-3263, 2011 WL 2555380 (D. Minn. June 28, 2011). (See also Admin. R. at 398-409, Aug. 13, 2012, Docket No. 5.) The Court will summarize only those facts necessary to understand Kirchner's objections to the R&R.
Kirchner's application for disability was originally denied on October 16, 2006 (Admin R. at 46-49), and reconsideration was denied on December 22, 2006 (id. 50-52). Kirchner requested a hearing, and Administrative Law Judge David Gatto issued his decision on February 26, 2009. (Id. at 4-13.) The Appeals Council denied Kirchner's request for review. (Id. at 1-3.) Kirchner then sought review in this Court which remanded the action for further development of the record. Kirchner, 2011 WL 2555380, at *3. The Appeals Counsel vacated the Commissioner's decision and remanded the case for rehearing before ALJ Diane Townsend-Anderson. (Admin R. at 487.) On April 3, 2012, the ALJ again issued an unfavorable decision. (Id. at 395-414.) The second ALJ decision is the final decision of the Commissioner. (Id. at 396.) See 42 U.S.C. § 405(g).
It is undisputed that Kirchner suffers from narcolepsy. (See, e.g., R&R at 7-12.) The Commissioner found that Kirchner's condition "has been treated with Adderall" and was "stable and controlled with medication." (Admin. R. at 405.) The R&R concluded that "[t]he record as a whole supports the ALJ's conclusion that Adderall controlled Kirchner's narcolepsy." (R&R at 18.)
During the hearing before the ALJ, the medical expert testified that "the narcolepsy has been an ongoing and significant problem," that Kirchner had "failed a number of typical medications," and that the "latest [medication] that was tried was the Adderall." (Admin. R. at 436.) When asked if the impairment from narcolepsy met or equaled any listing,
Kirchner's medical records contain multiple adjustments to Kirchner's narcolepsy medications. (See, e.g., id. at 200-201 (adjusting dose of Adderall); id. at 207 (changing prescription from Adderall to modafenil).) In March 2005, Kirchner asked to have his Adderall treatment resumed. (Id. at 210.) His physician resumed treatment with Adderall, and "encouraged [him] . . . to call/return for any worsening or new symptoms." (Id. at 214-214.) On several occasions between September 2005 and July 2006, Kirchner's treating physician noted that Kirchner's narcolepsy was "doing well." (Id. at 222, 229, 238, 266.) In October 2006, Kirchner complained that Adderall was not controlling his narcolepsy, and his physician discovered that a mistake had been made in filling his prescription. (Id. at 260-62 (noting that Kirchner "is, unfortunately, on half the dose that he should be taking").) On several occasions between December 2006 and January 2008, Kirchner's treating physician again noted that Kirchner's narcolepsy was "doing well." (Id. at 293, 301, 327.)
It is also uncontested that Kirchner suffered from venous insufficiency, a condition where the veins inadequately circulate the blood, especially from the lower extremities. (See, e.g., R&R at 5-7.) Kirchner was occasionally diagnosed with stasis dermatitis — a condition where blood pools in the veins, and blood and fluid leak out into the skin and other tissues — and ulcerations on his legs caused by the fluid accumulation. (See id.) There is no evidence in the record that Kirchner suffered from ulcerations that did not heal after treatment. (See R&R at 16-17 (summarizing evidence); Admin. R. at 404 ("[T]here is no indication of recurrent or persistent ulceration that did not heal following at least three month of prescribed treatment.").)
In 2011, this Court remanded Kirchner's case for further development because of a determination that the record was "muddled" with respect to the persistence and severity of Kirchner's venous insufficiency. Kirchner, 2011 WL 2555380, at *3. Kirchner was invited to submit more evidence either before or at his hearing. (See, e.g., Admin. R. at 492 ("If there is more evidence you want the ALJ to see, please give it to us as soon as possible . . . [or] you may bring it to the hearing."); id. at 502 (same).) Kirchner did not submit additional evidence of persistent ulcerations that did not heal following treatment. (See generally Admin. R. at 402, 404 (describing the record evidence of ulceration).)
Summary judgment is appropriate where there are no genuine issues of material fact and the moving party demonstrates that it is entitled to judgment as a matter of law. Fed. R. Civ. P. 56(a). A fact is material if it might affect the outcome of the suit, and a dispute is genuine if the evidence is such that it could lead a reasonable jury to return a verdict for either party. Anderson v. Liberty Lobby, Inc., 477 U.S. 242, 248 (1986). A court considering a motion for summary judgment must view the facts in the light most favorable to the non-moving party and give that party the benefit of all reasonable inferences that can be drawn from those facts. See Matsushita Elec. Indus. Co. v. Zenith Radio Corp., 475 U.S. 574, 587 (1986).
"The Social Security program provides benefits to people who are aged, blind, or who suffer from a physical or mental disability." Locher v. Sullivan, 968 F.2d 725, 727 (8
The Commissioner follows a five-step sequential analysis to determine whether a claimant is disabled, considering (1) whether the claimant is engaged in substantial gainful activity; (2) whether the claimant has a severe impairment; (3) whether the claimant's impairment meets or equals a listed impairment; (4) whether the claimant has sufficient residual functional capacity to return to his past work; and (5) whether the claimant can do other work existing in significant numbers in the regional or national economy. 20 C.F.R. §§ 404.1520(a)(4). A "listed impairment" is an impairment set out in SSA regulations. Id. §§ 404.1520(a)(4)(iii), 416.920(a)(4)(iii). A claimant is considered disabled if he or she suffers from a listed impairment or a disorder that is the medical equivalent of a listed impairment. Id. §§ 404.1520(a)(4)(iii), 416.920(a)(4)(iii), 404.1526, 416.926.
The Court "will affirm a denial of benefits when the substantial evidence on the record as a whole supports the ALJ's decision. Minor v. Astrue, 574 F.3d 625, 627 (8
Kirchner objects to the R&R's conclusion that the ALJ correctly determined Kirchner was not entitled to Social Security benefits. (Admin. R. 398-409.) Kirchner objects (1) that the ALJ incorrectly concluded that Aderall controlled Kirchner's narcolepsy and (2) that the ALJ should have found his disability met or equaled the listing for chronic venous insufficiency.
Kirchner objects to the determination that his narcolepsy was controlled by medication. Kirchner maintains that the conflicting evidence in the record required the ALJ to find that his narcolepsy was uncontrolled. But this Court must affirm a denial of benefits when "the substantial evidence on the record as a whole supports the ALJ's decision." Minor, 574 F.3d at 627. Although the Court recognizes that there were times when Kirchner's narcolepsy was not controlled by his medication, the majority of the evidence in the record suggests that the condition was well-controlled most of the time and supports the conclusion that Kirchner's symptoms did not reach the level of a disability.
"A treating physician's opinion is given controlling weight if it `is well-supported by medically acceptable clinical and laboratory diagnostic techniques and is not inconsistent with the other substantial evidence in [a claimant's] case record.'" Tilley v. Astrue, 580 F.3d 675, 679 (8
In sum, the Court finds that the substantial evidence on the record as a whole supports the ALJ's determination that Kirchner's narcolepsy was controlled. The Court will therefore affirm the ALJ's determination that Kirchner's narcolepsy did not rise to the level of a disability.
Kirchner also objects to the R&R on the grounds that his diagnosis of stasis dermatitis and venous insufficiency with periods of ulcerations should be sufficient to find that he suffered from a listed impairment or a disorder that is the medical equivalent of a listed impairment. See 20 C.F.R. § 404.1520(a)(4)(iii). The SSA regulations define impairment because of chronic venous insufficiency as follows:
20 C.F.R. § 404, Subpart P, Appendix 1, Listing 4.11. Kirchner argues that because "there is no evidence that [his ulcerations] did not exist for at least three months even after . . . treatment," the ALJ should have determined that his venous insufficiency met or equaled Listing 4.11. (Pl.'s Objections to R&R at 3, July 23, 2013, Docket No. 15.)
Kirchner bears the burden of proving that his impairment met or equaled the listing for chronic venous insufficiency. Carlson v. Astrue, 604 F.3d 589, 593 (8
Kirchner objects that even if his impairments do not meet the impairments of Listing 4.11, the ALJ should have found that his impairments equaled those of Listing 4.11. "To establish equivalency, a claimant `must present medical findings equal in severity to
After carefully considering Kirchner's objections to the R&R, the Court concludes that substantial evidence on the record as a whole supported the ALJ's determinations that Kirchner's narcolepsy was controlled by medication and that Kirchner did not meet all the requirements of a listed impairment for chronic venous insufficiency. The Court will, therefore, affirm the ALJ's determination that Kirchner was not disabled as defined by the Social Security Act, will grant Colvin's motion for summary judgment, and will deny Kirchner's motion for summary judgment.
Based on the foregoing, and all the files, records, and proceedings herein, the Court
1. Defendant's Motion for Summary Judgment [Docket No. 9] is
2. Plaintiff's Motion for Summary Judgment [Docket No. 6] is
