RUSS
v.
BARNHART

M.D. Fla. | 2005-03-29
No. 8:04-cv-00463
Snyder
363 F. Supp. 2d 1345 District Court, M.D. Florida (2005) Positive Treatment
Also reported at: 2005 WL 756745 · 2005 U.S. Dist. LEXIS 14879
Cited by 6 cases

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Holding

The court held that the ALJ erred in denying benefits based on a claimant's alleged failure to follow prescribed treatment, as the evidence did not sufficiently establish non-compliance or that such compliance would have restored the ability to work.


Facts & Procedural History

The claimant applied for Disability Insurance Benefits and Supplemental Security Income. The ALJ denied benefits, finding the claimant failed to follo…

The full statement of facts, procedural history, and disposition for this case are member content.

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Opinion of the Court

SNYDER, United States Magistrate Judge.

This cause is before the Court seeking review of the final decision of the Commissioner of Social Security (Commissioner) denying applications for Disability Insurance Benefits (DIB) and Supplemental Security Income (SSI) under the Social Security Act. Administrative remedies have been exhausted, and the case is properly before the Court.

Rachele Russ filed applications for DIB and SSI in 1999. After the applications were denied initially and on reconsideration, Administrative Law Judge John Marshall Meisburg Jr. (ALJ) conducted a hearing on March 28, 2001. At the hearing, testimony was given by Claimant, who was represented by counsel.

In a Decision dated May20, 2002, the ALJ found Ms. Russ was not entitled to benefits.

See

Transcript of Administrative Proceedings (Tr.) at 40, 42 (Finding 13), 43. The Appeals Council determined no basis existed for granting review and the Commissioner’s decision became final.

I. Standard of Review

“Disability” is defined in the Social Security Act as the inability “to engage in any substantial gainful activity by reason of any medically determinable physical or mental impairment which can be expected to result in death or which has lasted or can be expected to last for a continuous period of not less than 12 months.” 42 U.S.C. § 423(d)(1)(A);

see

42 U.S.C. § 1382c(a)(3)(A). In evaluating whether a

*1347

claimant is disabled, the ALJ must follow the sequential inquiry described in the regulations.

2

The Commissioner’s final decision may be reviewed by a district court pursuant to 42 U.S.C. § 405(g). “[F]actual findings are conclusive if ... supported by ‘substantial evidence,’ ” but the application of legal principles is examined' “with close scrutiny.”

Doughty v. Apfel,

245 F. 3d 1274, 1278 (11th Cir.2001) (quoting

Falge v. Apfel,

150 F. 3d 1320, 1322 (11th Cir.1998));

see also Davis v. Shalala,

985 F. 2d 528, 531 (11th Cir.1993) (“[N]o presumption of validity attaches to the ... determination of the proper legal standards to be applied in evaluating claims.”).

Substantial evidence has been defined as “ ‘such relevant evidence as a reasonable mind might accept as adequate to support a conclusion.’ ”

Falge,

150 F. 3d at 1322 (quoting

Richardson v. Perales,

402 U.S. 389, 401, 91 S.Ct. 1420, 28 L.Ed.2d 842 (1971)). “ ‘If the Commissioner’s decision is supported by substantial evidence, [the reviewing court] must affirm, even if the proof preponderates against it.’ ”

Dyer v. Barnhart,

395 F. 3d 1206, 1210 (11th Cir.2005) (per curiam) (quoting

Phillips,

357 F. 3d at 1240 n. 8);

see also Ellison v. Barnhart,

355 F. 3d 1272, 1275 (11th Cir.2003) (per curiam). In determining whether substantial evidence supports a finding, portions of the transcript are not viewed in isolation, but are examined for their impact upon “the record as a whole.”

Lewis v. Callahan,

125 F. 3d 1436, 1439 (11th Cir.1997). However, the existence of substantial evidence in the record favorablé to the Commissioner may not insulate the ALJ’s. determination from remand when he or she does not provide a sufficient rationale to link such evidence-to the legal conclusions reached:

See Keeton v. Dep’t of Health & Human Servs.,

21 F. 3d 1064, 1066 (11th Cir.1994).

II. Analysis

Plaintiff argues “[t]he ALJ erred in failing to apply the correct legal standards under20 C.F.R. § 404.1530 and Social Security Ruling 82-59 and his decision is not supported by substantial evidence.” Memorandum in Support of Plaintiffs Appeal of the Commissioner’s Decision (Doc. # 10) at 1. She contends the judge incorrectly determined that, she “failed to follow prescribed treatment and that if she had followed such treatment her ability to work would have been restored[.]”

Id.

at 5.

Where prescribed medical treatment would restore the ability to work, a claimant’s “ ‘refusal to follow [that] treatment without a good reason will preclude a finding of disability[.]’ ”

Ellison,

355 F. 3d at 1275 (quoting

Dawkins v. Bowen,

848 F. 2d 1211, 1213 (11th Cir.1988));

see

See Dawkins,

848 F. 2d at 1213,

In cases involving obesity, “[a] physician’s recommendation to lose weight does not necessarily constitute a prescribed course of treatment, nor does a claimant’s failure to accomplish the recommended change constitute a refusal to undertake such treatment.”

McCall v. Bow

*1348

en,

846 F. 2d 1317, 1319 (11th Cir.1988) (per curiam). “[Ljosing weight is a task which is not equivalent to taking pills or following a prescription.”

Hammock v. Bowen,

879 F. 2d 498, 504 (9th Cir.1989).

Here, the ALJ determined “[t]he claimant was disabled as of the alleged onset date of April 29, 1997.” Tr. at 42 (Finding 13). Nevertheless, he concluded the duration requirement had not been met because “failure to follow prescribed treatment has occurred and it is not justifiable[.J”

Id.; see also id.

(Finding 12) (“If the claimant had followed said prescribed treatment at the time of the alleged onset date, [she] would have been restored to substantial gainful activity[.J”).

The judge’s basis for denying benefits is not supported by substantial evidence. Concerning failure to follow prescribed treatment, he stated a physician had “urged [her] to continue losing weighty] but [she] failed to do so.”

Id.

at 39. While he also mentioned Plaintiff was placed on a diet,

id.,

the ALJ apparently equated compliance with success. He acknowledged—and did not discredit—her testimony “that she tried to follow the diet and that she did not eat very much. However, she said that she was still not able to lose weight.”

Id.; see also id.

at 245 (report of “no weight loss” despite reduced food intake post-surgery);

id.

at 404-06. Given the nature of obesity as acknowledged by the legal system, Ms. Russ’s mere “failure to accomplish the recommended change” does not establish a refusal of prescribed treatment.

McCall,

846 F. 2d at 1319.

The ALJ’s application of the law was flawed in another respect as well. Even assuming Claimant refused to comply with prescribed treatment, the judge lacked a sufficient basis to decide treatment compliance would have restored Plaintiffs ability to work. His conclusion in this regard is based on responses to interrogatories sent to a treating physician.

See

Tr. at 39, 379-80. This evidence falls short of showing even flawless adherence to a diet and exercise program would have resulted in an ability to maintain gainful employment. The physician opined simply that Plaintiffs condition may have improved were such treatment undertaken when first prescribed,

3

and that tardy compliance would result in improvement.

Id.

at 380. A potential for non-quantified improvement is too amorphous to justify concrete functional capacity findings. Accordingly, as has been observed, “[improvement does not equal an ability to work.”

Seals v. Barnhart,

308 F. Supp. 2d 1241, 1252 (N.D.Ala.2004). Since the ALJ marshaled no other support for his conclusion, he must be considered to have erred in applying the relevant standard. Though the ALJ’s decision about disability may have been a fairly close one,

see id.

at 40, in view of the errors discussed herein this case must be remanded.

III. Conclusion

In light of the foregoing, it is hereby ORDERED:

The Clerk of the Court is directed to enter judgment pursuant to sentence four of 42 U.S.C. § 405(g) and 1383(c)(3) RE

*1349

VERSING the Commissioner’s decision and REMANDING this -matter with instructions to1) reconsider whether Plaintiff refused to follow prescribed treatment, remaining cognizant of the fact lack of success in losing weight is not equivalent to noncompliance;2) re-evaluate, if appropriate in light of the resolution of instruction number1, whether Claimant’s ability to work would have been restored had treatment not been refused; and3) conduct any further proceedings deemed necessary.

Footnotes
1 The parties consented to the exercise of jurisdiction by a United States Magistrate Judge. Notice, Consent, and Order of Reference—Exercise of Jurisdiction by a United States Magistrate Judge (Doc. # 6).
2 The process involves five questions posed until a finding of disability is either precluded or mandated. The questions are as follows: (1) Is the claimant engaged in substantial gainful activity?; (2) If not, does the claimant suffer from a severe impairment?; (3) If yes, does the claimant’s impairment meet or equal one of the listed impairments set forth in 20 C.F.R. Part 404, Subpart P, Appendix 1?; (4) If not, can the claimant perform his or her former work?; (5) If not, can he or she engage in other work of the sort found in the national economy? See 20 C.F.R. §§ 404.1520(a)-(g); 416.920(a)-(g); see also Phillips v. Barnhart, 357 F. 3d 1232, 1237 (11th Cir.2004).
3 It is noted the doctor did not state a belief about whether Plaintiff complied with his advice. Rather, he indicated he did not know if such had occurred. Id. at 379. The resulting awkwardness of describing the doctor’s opinion as to what would have happened had she complied is introduced by the ALJ’s questioning, which itself assumes noncompliance. Also, the Court observes that while the ALJ at one point indicated the interrogatories would be revised in accordance with proposals made by Plaintiff's attorney, see id. at 76, the record does not include responses by the physician to the additional questions.
20 C.F.R. §§ 404.1530, 416.930. An ALJ must make explicit findings in this regard if benefits are to be denied.

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  • Griffis v. Astrue, 619 F. Supp. 2d 1215 (M.D. Fla. 2008)
    …ed substantial evidence favorable to the Commissioner, that “may not insulate the ALJ’s determination from remand when he or she does not provide a sufficient rationale to link such evidence to the legal conclusions reached.” Russ v. Barnhart, 363 F.Supp.2d 1345, 1347 (M.D.Fla.2005). When the Court can not discern the basis for the ALJ’s decision, a sentence four remand is often appropriate to allow the ALJ to explain the basis for his decision. Falcon v. Heckler, 732 F.2d 827, 830 (11th Cir.1984). Su…
  • …J is required to provide a sufficient rationale linking the record evidence to the RFC determination.” See Weber v. O'Malley, No. 8:23-cv-2723-AAS, 2024 WL 4589790, at *4 (M.D. Fla. Oct. 28, 2024) (citing Dyer, 395 F.3d at 1211 and Russ v. Barnhart, 363 F. Supp. 2d 1345, 1347 (M.D. Fla. 2005)); Salter v. Astrue, No. CA 11-00681-C, 2012 WL 3817791, at *3 (S.D. Ala. Sept. 4, 2012) (“[T]he ALJ must link the RFC assessment to specific evidence in the record bearing upon the claimant's ability to perform the physical, m…
  • …ndings in the RFC assessment that Plaintiff would be off task an average of 5% each hour and miss on average one day of work each quarter due to her limitation in the ability to concentrate is supported by substantial evidence. See Russ v. Barnhart, 363 F.Supp.2d 1345, 1347 (M.D. Fla. 2005) (“The existence of substantial evidence in the record favorable to the Commissioner may not insulate the ALJ's determination from remand when he or she does not provide a sufficient rationale to link such evidence to the legal…

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