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Krispin v. Colvin

United States District Court, W.D. Wisconsin

June 20, 2016

CAROLYN W. COLVIN, Acting Commissioner of Social Security, Defendant.



         Invoking 42 U.S.C. § 405(g), plaintiff Heidi Krispin seeks judicial review of a final decision of defendant Carolyn W. Colvin, the Acting Commissioner of Social Security, which denied her application for Social Security Disability Insurance Benefits and Supplemental Security Income. On May 27, 2016, the court heard oral argument on plaintiff’s contentions that the administrative law judge (“ALJ”) erred in the following respects: (1) failing to explain his finding that Krispin’s impairments did not meet or medically equal the requirements for Listing 1.04 (disorders of the spine); (2) not properly considering Krispin’s obesity in accordance with Social Security Ruling (“SSR”) 02-1P, Evaluation of Obesity; and (3) without medical support or explanation, concluding a treating physician’s opinion that Krispin could perform light work on a part-time basis is the equivalent of a residual functional capacity (“RFC”) for full-time, sedentary work. While finding that the ALJ had articulated a sufficient basis for his decision with respect to Listing 1.04, the court will remand for further consideration of the treating physician’s opinion and the impact of Krispin’s obesity, as well as a more thorough explanation of their effects on her residual functional capacity.


         I. Relevant Work History

         Krispin claims a disability onset date of July 1, 2008, based on low back and hip pain. She was 44 years old at the time of her alleged onset date and 47 years old when she applied for benefits. Krispin is a high school graduate with work experience as a food preparer and dishwasher at a restaurant. Between 2008 and 2012, Krispin worked 12 hours a week, and in January 2012, she reduced her work to 3.5 hours, two days per week, for a total of 7 hours a week. (AR 55-56.) Krispin stopped working altogether in January 2013. At the hearing before the ALJ on June 25, 2013, Krispin testified that she had been using a cane on a fulltime basis since March 26, 2013, and that she had to change her position every 10 minutes. (AR 58-60.)

         II. Relevant Medical History

         Krispin initially sought treatment at a clinic for lower back pain and abdominal cramping on July 29, 2008. (AR 410-11.) She saw Dr. Gill on August 6, 2008, and he noted that her x-rays showed severe facet osteoarthritis changes from L3-4 through L5-S1 and some evidence of degenerative spondylolisthesis. Gill prescribed a muscle relaxant, anti- inflammatories, stretching, use of heat and ice, and physical therapy. He also noted that Krispin was obese. (AR 407-10.)

         On February 6, 2009, Dr. Gill diagnosed Krispin with degenerative spondylolisthesis at L4/5 and left L5 radiculopathy. He noted that a magenetic resonance imaging study (“MRI”) taken on October 2008 revealed grade 1 spondylolisthesis at L4-5 with extensive facet hypertrophic changes resulting in moderate to severe central canal stenosis. As a result, Gill prescribed pain medications and referred Krispin to Dr. Benjamin Hackett, an orthopedic spine surgeon. (AR 400-02 and 676.)

         Krispin saw Dr. Hackett on February 20, 2009, who noted that she was moderately obese and suffered from degenerative spondylolisthesis at L4/5, multi-level lumbar spondylosis at L3/4 and L5-S1, and L4-5 spinal stenosis. Dr. Hackett recommended core strengthening, spinal stabilization, and a nerve root block for Krispin. (AR 674-75.) Krispin saw Dr. Hackett again several months later, on August 14, 2009. At that time, Krispin reported that she was doing quite well after having a L-5 nerve block on the left side. (AR 672.)

         On October 16, 2009, however, Krispin returned to Dr. Hackett, reporting that she was having increasing pain down her left leg. Hackett recommended an epidural steroid injection at L5-S1, as well as physical therapy. (AR 670-71.) Krispin next saw Hackett six months later, on April 30, 2010, when she reported that the steroid injections had given her excellent relief from the radicular symptoms, but that she was now experiencing low back pain, which was relieved by sitting. (AR 668-69.)

         Krispin continued to report receiving significant relief from steroid injections throughout 2010. For example, on September 1, 2010, Dr. Hackett noted that Krispin was working without restrictions and doing fairly well with her radicular symptoms due to “excellent relief” from the steroid injections. (AR 666-67.) On December 15, 2010, Hackett again noted that Krispin had 100% pain relief since her steroid injection a week before. (AR 664.)

         However, Krispin’s condition again took a turn for the worse in the summer of 2011, when she began experiencing hip pain. In June 2011, Dr. Aylin Akay diagnosed her with trochanteric bursitis in her left hip for which she received oral steroid medication, as well as a steroid injection. (AR 346-62, 662.) Although Krispin reported to Dr. Hackett on July 20, 2011, that the injection relieved her symptoms temporarily, her radicular pain had increased. In response, Hackett gave her a trochanteric bursa injection and recommended additional injections for her lumbar radiculopathy. (AR 661-62.) When Krispin reported on August 31, 2011 that she experienced only short-term relief from her latest injections, Hackett referred her to Dr. Scott Stuempfig for nonoperative pain management before considering spinal surgery. (AR 659-60.)

         On September 27, 2011, Dr. Stuempfig noted that Krispin had 70% improvement in her pain symptoms after a steroid injection. In particular, Krispin reported being able to walk farther, stand longer, and being more successful at work. (AR 738-39.) Although Krispin complained of cramping and increased pain on October 4, 2011, Stuempfig further noted on November 8, 2011, she had experienced persistent improvement since her steroid injection. Still, she told Stuempfig that her back pain flared when she was at work and in the evenings.

         During this period, Krispin was taking multiple medications, including gabapentin, meloxicam and tramadol. (AR 734-37.) In a progress note dated January 17, 2012, Stuempfig noted that Krispin reported being able to work for ...

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