Opinion ID: 2996582
Heading Depth: 2
Heading Rank: 1

Heading: Jens’s Impairments

Text: At the time of the ALJ’s decision, Jens was forty-six years old. After Jens was diagnosed with psoriasis in January 1997, Dr. Richard Leer, his primary physician, referred him to the Mayo Clinic for further evaluation. At the Mayo Clinic, psoriatic arthritis in Jens’s right foot was confirmed by X-ray. Jens was offered a right shoe insert, injection therapy of both knees, and inpatient ultraviolet-B therapy. In September 1997 Jens was admitted to the Mayo Clinic for tar and ultraviolet-B therapy. At that time, Dr. Toshihiko Maruta concluded that Jens had developed an affective disturbance due to his physical impairments. Dr. Alan Duncan opined that Jens “carries the clinical diagnosis of psoriatic arthritis, causing significant knee discomfort and intermittently preventing him from working.” In April 1998 Dr. Leer found Jens’s psoriasis “under fair control,” and noted that Jens suffered from insomnia. Jens’s rheumatologist, Dr. Howard Swanson, concluded in July 1998 that Jens’s psoriasis “looks much better than last year.” He further observed that Jens’s “pain is still out of proportion to the exam lab or x-ray findings.” In August 1998 agency psychologist Dr. Joseph Roe performed a consultative psychological examination of Jens. Dr. Roe concluded that Jens had an adjustment disorder and noted that “pain appears to interfere with [Jens’s] ability to concentrate and think clearly.” In addition, agency physician Dr. Michael Haase examined Jens and observed No. 03-1377 3 that he suffered from psoriatic arthritis and depression, but that his psoriasis was not severe. Over the next two years, Jens continued to see Drs. Leer and Swanson. In January 1999 Dr. Leer remarked that Jens was “somewhat depressed,” and that Jens had “significant psoriasis of the scalp and scattered areas of the trunk.” In February 1999 Dr. Swanson noted that the psoriasis was “moderate, but better than in the past.” Jens returned to the Mayo Clinic in November 1999 where Dr. Duncan concluded that Jens suffered from possible psoriatic arthritis and myofascial pain syndrome. Dr. Joseph Holt performed a consultative examination at the request of the state agency in February 2000. Dr. Holt noted that Jens’s medical problems included psoriasis, insomnia, lower extremity pain, and symptoms consistent with mild depression. In his recommendations, Dr. Holt opined that Jens’s “chronic pain appears to significantly impact his abilities to physically interact on a daily basis,” but that Jens is “able to sit quietly and do activities with his upper extremities apparently with no difficulty.” Jens returned to Dr. Leer in May 2000 for a periodic health assessment. Dr. Leer noted that Jens had widespread psoriatic lesions, but also that his sleep pattern was “good” and his mental status was “entirely normal.” Dr. Leer completed a functional capacity evaluation of Jens, recommending that Jens is capable of performing sedentary work for eight hours a day, forty hours a week.