The Ho norab le J. Ro nnie Greer, U nited States District J udg e for the E astern District of * Tennessee, sittingby

des ig nation. NO T R EC OM M EN DE D F OR F UL L- TEX T P UB LIC AT ION F ile Nam e: 07a0670n.06 F iled: Septem ber 7, 2007 Nos. 06-6582 UN ITED STA TES C OU RT OF AP P EA LS F OR THE SI XT H C IR CU IT
RACHEL KENNEDY ) ) Plain tif f- Ap pe lla nt, ) ) v. ) ON APPEALFROM THE U NI TED ) STATES DI STRI CT COURT FOR MICHAEL J. ASTRUE , ) THE EAS TER N DI S TR I CT OF COMMISSIONER OF SOCIAL ) KENTUCKY SEC URITY ) ) Defendant-

Appellee

. )
Before: CLAY and SUTTO N, Circ uit Jud ges; and GREER, Distr ict Judge. * GREER, District Judge . Rache l Kennedy (Ke nnedy

) wa s found disabled a s of Se pte mbe r 1 , 1 99 4, by

the Soc ia l Se c ur ity

Ad min ist ratio n ( SSA ) a

nd awa rd e d s up ple me nta l se c ur ity inc o me ( SS I ) b e n e f

it s . SS A f

o un d th a t K e n n e dy ’ s p s y c h o lo g ic a l d is o r d e r an d o b e s it y im p osed limit ations that prec luded work a nd rende red he r disabled. On Ma y 14, 2003, SSA notified Kenne dy that a re view of he r medica l rec ords showed that her c ondition had improved and she was no long er disabled. Her disability benef its were te rminated in Jul y , 2003. After a hea ring befor e an administrative law judg e (A L J ), the initial determination wa s upheldand the AL J found that the medical e vidence established an “ im p ro vement in the cla imant’s psy cholog ical and phy sicalNo. 06-6582

Kennedy v. Astrue

T he ALJ ’ s de c i s i on is in t e rna l l y co nt r a di c t or y on th e is s ue of whe n d i s abi l i t y ce a s e d. At p a ge 1 12 of the A LJ’s decision , th e A LJ finds th at disa bility ceas ed a s of Febru ary

1, 20 02, and

that her elig ibility for benefits ended

as of April 1, 20 02. O n p ag e 13 of the A LJ’s decision , h owe v er, the A LJ finds that Kenne dy ’s disa bility ceas ed a s of May

1, 20 03, and

her elig ibility

ceas ed a s of J uly

1, 20 03. Kennedy listed her b irth da te as Febru ary 12 , 1 971, on

her SSI app lication and testified at the 2 hearingbefo re the AL J that her d ate of birth is Febru ary 12 , 1 971. A ll m edical records in the file a lso indicate a da te of birth o f Fe bruary 12 , 1 971. The AL J , h owe v er, found a date o f birth of July

4, 19 73. No explan ation for the A LJ’s findingis a pparen t from

the record. 2 c on dit ion ” and

t h a t , wh i l e h e r i mpa ir

me nts re ma in s e ve re , s he re ta ins the re sid ua l f un c tio na l c a

pa c ity to perfor m work “e x cept wor

k that require s more than a limited ability to withstand work stresses in a ro uti ne e ig ht h our d ay ” a t all exe rt ion a l lev e ls. Th e AL J det e rm ine d th a t K e nn e dy ’s dis a bil ity
cea sed as of

May 1, 2003. 1 After SSA’s a ppeals council denied her reque st f or revie w, Kenne dy filed suit in t he fede ral district cour

t. The district c ourt g rante d summary judgme nt to the Comm issioner of Social Se c ur ity (C omm iss ion e r) and thi s app e a l fol low e d. F or the re a so ns se t for th be low , we REV ERS E the judg ment of the district cour t with inst ructions to rema nd the case t o the Commiss ioner for an
awa rd of c on tin uin g be ne fi ts. F ACTUAL AND P ROCEDURAL BACK GR OUND At th e t i m e o f t h e i n i t i al d et erm i n at i o no f d i s ab i l i ty , Ke n n ed y wa s a 2 3 y ea r ol d

h i gh school g raduate who had c ompleted one y ear of colleg e with no rele vant work history
. She repor ted 2 phy sic a l and

me nta l pr ob le ms o f h ig h b loo d p re ssu re , d e pr e ssi on , h or

mon e imb a lanc e , f

lui d rete ntion, ove rwe ight, TB “g erm” and bronchitis. She was de termined to be disable d by SSA as the result of an aff

ective disorde r (de pressive sy ndrome) a

nd morbid obesity . As part of the initialNo. 06-6582

Kennedy v. Astrue

3 deter mination process, she was refer red by SSA for both a medical and a psy cholog ical consultative examination. A psy cholog ical consultative e x amination was pe rfor med by Bob Wi n s t o n, M.D., on Fe bruar

y 16, 1995. Dr. Winston described Ke nn ed y as an o b ese, white fema le wea ring
a pp ro pr iate and

c le a n c lot hi ng who wa s c oo pe rativ e thr ou g ho ut t he int e rv ie w. She wa s a le rt , coher ent and logic al but he r mood was de scribed a s “sad a ffe ct.” Dr . Wins ton describe d her insig ht
a s “ sh a llo w” and jud g me nt a s “ fa ir .” Dr . Win sto n d ia g no se d “ ma jor de pr e ssi on , r e c ur

re nt” (A xis I ) and obe sity , tuberc ulosis by history , and hy perte nsion (Axis I I I ). Kennedy had a g lobal assessment function (“ GAF ”) sc ore of 55. Dr. Winston described he r as “ marke dly impaired.” A consultative medic al exam was done by Shantae L

ucas, M.D., on January

28, 1995. Dr. L ucas r eporte d Kenne dy ’s weight as 276 pounds. Kenne dy could bend to 90 deg ree s and squat without difficulty . She had no neur ologic al deficits and joint flexi on was norma l. Her dia g nosis was morbid obesity , well controlled a sthma and we l l controlled hy perte nsion. Dr. Lucas f ound Ke nn e dy ’s “ tol e rance for sta nd ing , w a lki ng , s too pin g , b e nd ing , li ft ing , s itt ingand tr ave lin g is diminis hed by

obesity ” and de scribed he r func tional impairment to be mild. Ba sed upon the ava ilable medica l and psy cholog ical data , state ag ency phy sicians found Ke nnedy

disabled bec ause of

aff ective mood disorde r and obe sity
. T h e st ate a g ency phy sic ians no te d s lig ht t o m od e rate re str ic tio ns of da ily a c tiv iti e s, mod e rate dif fi c ult ie s in
ma int a ini ngso c ia l f

un c tio nin g , mo de ra

te ly lim ite d a bil ity to w or k in c oo rd inatio n wi th o r p ro ximity to oth e rs wi tho ut be ing dis tr a c te d by the m and mod e ra te ly lim ite d a bil ity to i nte ra c t a

pp ro pr iate lyNo. 06-6582

Kennedy v. Astrue

4 with the g ener al public.

Kenne dy was det er m i ned to have the mental ca pacity to understand/re member ins tr uc tio ns ; pe rf

or m un sk ill e d/s e mi- sk ill e d ta sk s f or a de qu a te time i nte rv a ls; re sp on d a de qu a te ly in settings that do not require complex interac tion or coope ration with others; and a dapt to the usual demands of a

competitive work se tting. A state ag ency phy sician found e x ertional li mitations of
oc c a sio na lly

lif tin g and /or c arr yingtw e nty

p o u n d s ; f r e q u e nt l y l i f t i n g a n d / or c arr yingte n ( 10 ) p ound s; standing and/or wa lking at least two hours in a n eig ht-hour work day ; sitting about six hours in an eig ht-hour wor

k day ; and unlimited pushing and/or pullingbased upon her o b es ity and other conditions. Duringthe y ear s betwee n the initial onset of disability and the 2003 revie w initiated by SSA, Kennedy

soug ht treatment for

a var iety of maladie s and wa s presc ribed medic ation for various conditions throug h her f amily phy sician. She had a

r ecur rent diag nosis of depre ssion, treated with Z oloft, and obesity , treated most rece ntly with weig ht loss medications. Her we ight f luctuated from a hig h of 320 pounds on J uly 2, 2002, to a low of 247 pounds on June 23, 2004. Duringthe re view proc ess, Kenne dy was re fer red to Ga ry Mary man, Psy .D., license d clinical psycholog ist, for a consultative psy chiatric exam. She was examined on March 18, 2003. Mary man desc rib ed her to be modera tely obese, c asual, c lean a

nd appropr iately

attired. She wa s fully aler t at the time of the examination, see med to be rea sonably well composed and “show ed no signs of anxiety , timidi ty , or depr ession.” Mar y man diag nosed dy sthy

mic disorder ( Axi s I ) and a n axis I V rating of

sever e. Ke nnedy

had a G AF sc ore of

60. In summary , Mary

man said:No. 06-6582

Kennedy v. Astrue

5 Ms. Kennedy

was re g arde d to b e an i ndividual of sufficie nt intellectual ability

that would permit her to unde rst an d , retain, and car ry o ut a simple to somewhat more c omplicated instruction and task. In the main, duringthis ex amination she showed the likelihood that she would have sufficie nt focus, conc entration, and persistenc e to w h e r e s h e s h o u ld

b e a b le to c o mp le te an d

c ar r y o u t a w o rk assig nment within a rea sonable time fr ame a nd acr oss a routine wor

k schedule . I t is felt that she should have no pr oblems interac ting appropr iately

with fellow worke rs and supe rvisors and would not appea r nec es s ar i l y

prec luded from having the ability to interac t and de a l w iththe g e ne ra l pu

bli c reason a

bly we ll, e ve n th ou g h it

wo uld c e rt a inl y a pp e ar t hat sh e wo uld

be mod e ra

te ly lim ite d in that r e sp e c t. F ina lly , it wo uld a pp e ar that this y oung la dy sh ou ld b e a ble to a dju st and a da pt r e a so na

bly we ll to str e sse rs and pr e ssu re s a sso c iate d w ith a routine w ork atmospher e. She would appe ar to be better suited f or a medium to lower stre ss work environme nt and so m ew hat more restric ted in a more fast pac ed and hig h pressure work atmosphere. No consultative medical exam wa s obtained duringthe re view proc ess; howeve r, a consultation reque s t was sent to an a g ency phy sician see king a ssessment of Ke nnedy ’s phy sical disorders. The reques t , n o t i ng alleg ations of “a sthma, TB, vision, stomach,” soug ht a cur rent phy sic a l a s s e s s me n t an d s ay s “ lo o k s L T S. ” C. H e r n an d e z, M
. D
. , w r o te in r e s p o n s e : “You ar e
corr ect! ! L TS. Thanks.” I ntere stingly , Kenne dy ’s obesity was not noted a

nd no assessment of he r obesity and its eff

ects on he r ability

to do work re lated ac tiviti es wa s completed. AN AL YSI S Pursuant to 42 U.S.C. § 405(g) , this Court has jur i s d i ct i o n to reviewthe Commi ssioner' s deci s io n s . Ju d ic ia l reviewof the Commissioner' s decisions is limi ted to deter mining whether the Commiss ioner' s findings are supported by substantial evidence and whe ther the Commi ssioner employ ed the pr oper le g al standar ds. Ri c ha rd so n v . P e ra le

s, 402 U.S. 389, 401, 91No. 06-6582

Kennedy v. Astrue

6 S.Ct . 1420, 1427, 28 L .Ed.2d 842 (1971). Subst antial evidence is more tha n a scintilla of evide nce but less than a pre pondera nce; it is such re levant evide nce a s a r easona ble mind might ac cept a s adequate to support a conc lusion. Kir k v . S e c re tar yof He alt h &Hu ma n S

e rv ic es, 667 F.2d 524, 535 (6th Cir.1981), cert. de nied, 461 U.S. 957, 103 S.Ct . 2428, 77 L .Ed.2d 1315 (1983). This Court does
n o ttr y th e c a s e d e n o v o , n o r

r e s o l v e c o n f

l i c t s i nt h e e v i d e n c e , n o r d e c i d e qu e s t i o n s o f c r e d i b i l i ty. B r a i n a rd v . S e c r e ta r yo f H e a l th &H u m a n S e r v i c e s, 88 9 F .2 d 6 79 , 6 81 (6 th C ir .1 98 9) ; Garner v. He c k le r, 745 F.2d 383, 387 ( 6th Cir.1984). I n d e te r mi n in g th e e xis te n c e o f

s u b s ta n ti a l e v id e n c e , th is c o urt m u s t e xami n e the administrative re cord a s a whole. Kirk, 667 F.2d at 536. I f the Commi ssioner' s decision is supported by substantial evidence , it must b e af fi rm ed even if

the re viewingcourt would de cide the matter d i f f e r e n t l y, Kin se lla v . Sc hwe ik e r, 708 F.2d 1058, 1059 ( 6th Cir.1983), and eve n if substantial evidenc e also supports the opposite conc lusion, Mullen v. Bowe n, 800 F.2d 535, 545 ( 6th Cir.1986) ( en banc ). When the cessation of benef its is at issue, as here , the centr al question is whether the claimant’s medic al impairments have improved to the point where she i s able to perform substantial g a inf ul a c tiv ity . 4 2 U .S. C. § 42 3( f) (1 ). I mpr ov e me nt is me a sure d fr om “ the mos t r e c e nt f avo ra ble decision” that the claimant wa s disabled. 20 C.F.R. § 416.994(b)( 1)(i). There is no presumption of continuing disa

bility
. Cutli

p v. Sec retary of Health and Human Se rvice s , 25 F.3d 284, 286- 287 n.1 (6th Cir. 1994). Instead, the Commi ssioner applies the procedure s that are outlined in 20 C.F.R. §§ 404.1594 and 416.994 to deter mine whether

a cla imant’s dis ability

has ende d and that she is nowNo. 06-6582

Kennedy v. Astrue

7 able to wor

k. The fir st part of the e valuation proc ess, then, foc uses on medical improve ment. The imp le me nti ngre g ulatio ns de fi ne a me dic a l im

pr ov e me nt a s “ any decr eas e in t he me dic a l se ve ri ty of your impairment(s) which wa s prese nt at the time of the most rec ent favorable medical de cision that y ou wer e disabled or

continued to be disabled.” 20 C.F.R. § 404.1594(b)( 1). A de termination of medica l improvement “must be based on chang es (improve ment) in the sy mptoms, si g ns and/or laboratory

finding s associate d with y our impairment(s) .” Id. And a medic al improvement is re lated to an individual’s ability to work only

“if ther e has be en a de cre ase i n t h e s ev er i ty . . . of the imp a ir me nt( s) pr e se nt at the tim e of the mos t r e c e nt f avo ra ble me dic a l de c isi on

and an in c re a se in y our fu nc tio na l c a

pa c ity to do ba sic wo rk a c tiv iti e s. . .” 20 C.F .R. § 40 4. 15 94 (b )( 3)
. S ee al so Nie rzw ic k

v . Co mm iss ion e r o

f So c ial Se c ur ity , 7 Fe d. Appx. 358, 2001 W L303522 (6th Cir. 2001). The sec ond part of the evaluation process re lates to ability to eng ag e in substantial g a inf ul a c tiv ity
. He re the imp le me nti ng re g ulatio ns inc or po rate many

of the sta nd ard s se t f

or th i n regulations gove rninginitial dis ability deter minations. See 20 C.F.R. § 404.1594(b)( 5) and ( f)( 7). Th e dif fe re nc e , o f c ours e , is th at the ult imate burd e n o f p ro of lie s w iththe Com mis sio ne r i n termination proce eding s. Id. ; Griego v. Sullivan , 940 F.2d 942, 944 ( 5th Cir. 1991).

Wit h thi s le g a l f

r ame w o r k in mi n d , w e h av e r e v ie w e d th e me d ic a l r e c o r d s and the decision of the AL J
. This c ase turns on whether substantial evidence shows there has bee n medical imp ro ve me nt i n K e nn e dy ’s imp a ir me nts , oth e r tha

n imp ro ve me nt whic h is no t r e late d to he r a bil ity to w or k. We c on c lud e that th e re is n ot.No. 06-6582

Kennedy v. Astrue

8 P sy c hol og ic al I m pai r m e nt The AL J ’s dec ision point ed to th r e e f a c to r s “ c o n s is tent with significa nt improvement in psy cholog ical func tioning.” ( AL J De cis ion at 6). Ac cordingto the AL J , “[n] o treating or examining source has noted a blunted eff ect or depre ssed mood” since 1995 and GAF score s increas ed from 55 to 60. Id. The AL J also noted that the state a g ency psy cholog ical consultant
a sse sse d mi ld l imi tatio ns in a c tiv iti e s of da ily liv ing , mo de rate lim itatio n in so c ia l f un c tio nin g , mi ld li mi tati o n s in c o n c e n tr a ti o n , p e r s is te n c e an d p a c e , an d th a t s h e c o u ld “ un d e r s ta n d , r e me mb e r

and
car ry out, and sustain simple tasks, adapt to workplac e cha ng es and function more e ffe ctively in a task verse s public setting.” Id. a t 7. Withthe e xce pti on of Ke nn e dy ’s a

bil ity to f un c tio n e ff

e c tiv e ly in a pu bli c se tti ng , w hic h wa s not as se sse d in 1995 , the se fu nc tio na l abi lit ie s ar e the same a s th os e assessed in 1995.

W h i l e t h e A LJc o r

r e c t l y p o i nt e d t o v ar i o u s f

un c t i o n a l a

b i l i t i e s p o s s e s s e d

b y K e n n e dy, including he r ability

to u n derstand, r etain and c arr y out simpl e to somewhat more complicated instructions and tasks, sufficie nt focus, conc entration and persistenc e to be a ble to complete a

nd
car ry out a work a ssignment a

nd her a bility to interac t appropriately

with fellow worke rs, no eff ort was made by

the AL J nor any

medical sourc e to c omparehe r a bil iti es or her

lim itatio ns to t

ho se possessed at the t i m e o f t he initial determination. Medica l improvement is any decr ease in the
me dic a l se ve ri ty of the c la ima nt’ s imp a ir

me nt whic h w a s p re se nt a t th e tim e of

the pr ior fa vo ra ble decision. Medica l improvement “is deter mined by a compa ri son of prior a

nd curr ent medica l
e vid e nc e . . .” 20 CF R § 4 04 .1 59 4( c )( 1) . As not e d a bo ve , K e nn e dy

a pp e ars to h ave ha d e sse nti a llyNo. 06-6582

Kennedy v. Astrue

9 the s am e fu n ctional abilities 1995 as these note d by the AL J in support of his finding of medical improvement. The c onclusions of t h e C o m missioner and the AL J that these func tional abilities indicate medic al improvement is not supported by substantial evidence and is in fac t contrar y to the evidenc e in the re cord.

The AL J ’s finding that “[n] o treating or examining source has noted a blunted aff

ect or depr essed mood” since 1995 is also contradic ted by the re cord. Contra

ry to the Commi ssioner’s
asse rtions that Dr. Mar

y man found no sig ns of depr ession on continuing disa bility revie w, Dr. Mary man’s diag nosis wa s dy sthy mic disorder, listed as a mood disorder c hara cter ized by “a chronic all y

depre ssed mood” in the Di ag no sti c an d S

tat ist ic al M

an ua l of Me nta l D iso rd

e rs , 4 th Edition. (DSM-I V). Ke nnedy ’s tre a ti ng phy sician diag nosed her repe atedly

from 1994 throug h 2003 as suffe ringfrom depr ession. I t is true that Dr. Mary man did not r eport that he observe d a blunted aff ect on the date of his e x amination; how ever , such a fa ilure to observe this condition on t he day of examination does not l o gi cally lead to a c onclusion of medica l improvement. L ikewise, Dr
. Mary man’ s o bs e rv a tio n th a t K e nn e dy , at th e tim e of the e xami natio n, “ sh ow ed no si gn s o f a c ute
e mot ion a l di str e ss” and

“ no sig ns of anxie ty , timid ity , or d e pr e ssi on ” do e s n ot n e c e ssa ri ly ind ic a te the lack of

“depr essed mood,” which “is consistent with signific ant improvement in psy cholog ical function.” Perhaps the most troubling aspec t of the Commissi oner’ s posit i o n conce rning Kenne dy ’s psy cholog ical impairment re lates to her G AF sc ore. D r. Winston assigned a GAF score of 55 in 1995. Dr. Mary

man found a 2003 GAF equal to 60. The AL J considerd the incre ase f romNo. 06-6582

Kennedy v. Astrue

10 55 to 60 to “ref

lect improveme nt in mental functioning ” and the Commi ssioner points to the curre nt
score of 60 as a

n “improved G AF.” (Appe llee’s B rief at 15). A G AF s co r e o f 6 0 i n d i ca t es a m o d er at e i mp ai rm en ti np s y ch o l o gi ca l fu n ct i o n i n g. See Kor ne c k yv . Co mm iss ion e r o

f So c ial Se c ur ity , 167 Fe d. Appx. 496, 503 (6th C ir. 2006) (e xpla ini ngthat a

“ GA F of 51 -6 0 in dic a te s mo de ra

te sy mpt oms ( e.g ., flat af

fec t and circ umstantial speec h, occa sional panic attacks), or moderate difficulty

in social, occ upational, or school fu n ct i o n i n g ( e.g . f

e wf r ie n d s , c o n f

li c t w it hp e e r s o r

c o - w o r kers) .” Id. (interna l quotation marks
o m i t t ed ) G AF i s a c l i n i ci an ’s s u b j ec t i v e ra t i n g o f an i n d i v i d u al ’s o v er al l p s y ch o l o gi ca l fu n ct i o n i n g. A GAF score may

help an AL J assess mental RF C, but it is not raw medica l data. Rather , it allows
a men tal he a lthpr of

e ssi on a l to tur

n me dic a l si g ns and

sy mpt oms int o a

g e ne ra l a sse ssm e nt, understanda

ble by a lay person, of

an individual’s mental func tioning. Id. at n.7. F ur the rm or e , th e Commis sio ne r “ ha s d e c lin e d to e nd or se the [GA F ] sc or e fo r ‘ us e in the Social Security

and SSIdisability

prog rams,’ a

nd has indicated t h at [ GA F] score s have no ‘direc t corre lation to the severity require ments of the mental disorders listings.’” DeBoard v

. Com mi ssi on e r o f So c ial Se c ur ity , 2 1 1 Fe d
. Ap p x . 4 1 1 (6 thC i r. 2 0 0 6 ) ( qu o t i n g W ind v . B ar nh ar t , No. 04-16371, 2005 WL 1317040, at *6 n.5, 133 Fe d. Appx. 684 (11th Cir. June 2, 2005) (quoting 65 Fe d. Reg
. 50746, 50764-65 (Aug . 21, 2000)). The GAF score s, theref ore, a re not ra w medica l data and do not ne cessa

rily indicate improved sy

mptoms or mental functioning . Even if that we re the ca se, the improvement in sc ore alone has not be en shown to be signific ant in this case since the 19 95 GA F sc or e (5 5) is i n th e same ra ng e a s th e 20 03 sc or e (60 ). Both s c or e s in dic a te mod e rateNo. 06-6582

Kennedy v. Astrue

The AL J ’s dec ision cites a weig ht of 285 poun ds in April, 2003
. This was actua lly the weig ht 3 docum ented in the m edical records for May 28 , 2 003. 11 sy mptoms or moderate diff

iculty in social, occ upational or school functioning
. The argument of the Commis sio ne r a

nd the fi nd ingof th e AL J that th e inc re a se d G AF sc or e re fl e c ts “ imp ro ve me nt i n mental func tioning” is not supported by substantial evidence
. Obesity At the time of the prior deter mination, Kennedy

weig hed 276 pounds. B ased upon her “ morbid obesity ,” a state ag ency phy sician, L og an M. Maha ffe y , M.D., found ex er tional limit ations with lifting, standing and sitting. The ag ency phy sician found that Ke nnedy had the ph y s ic a l f

un c ti o n a l c a

p a c it y o f li f ti n g an d /o r c ar r yin g 2 0 p o un d s o c c a s io n a ll y an d 1 0 p o unds fr e qu e ntl y , of sta

nd ing a t le a st tw o ho ur s in an e ight- ho ur

wo rk da y (b ut n ot a bo ut 6 ho ur s in

an e ig hthour workda

y ) and of sitti ng about six hours in an eig ht-hour wor kday . Dr. Mahaffe y

also found
occa sional (occ urringfrom ver y littl e up to one- third of an eight- hour workda y , cumulative) limit ations in climbing, bala ncing , stooping, ke eling , crouc hing a nd cra wling. On April 30, 2003, the day befor e the AL J deter

mined her disability

to have c ease d, Kenne dy weig hed 299 pounds. At the time of her hear ing on April 13, 2005, Kenne dy weig hed 265 3 pounds. Throug hout the entire pe riod betwe en the 1994 decision and the 2003 decision, Kennedy ’s weig ht fluctuated. The only medical e vidence in the file conce rning any phy sical impairment is the repor t of a state ag ency phy sician, C
. Her nandez, M .D. Dr. Hernande z’s total repor t consists of the handwr itten notation: “You are corr ect! ! L TS. Thanks.” F rom this notation, the AL J conclude s, byNo. 06-6582

Kennedy v. Astrue

SSR 02

- 1P prov ides th at SS A will c onside r ob esity to hav e m edically

im prov ed if an 4 indiv idual m aintains a co nsistent loss o f at le ast tenperc ent o f bo dy w eig ht for at least twelv e m onths. 12 compar ing D r. He rnande z’s conclusion of “less than se vere phy sical impairments” to the limitation in 1 99 4 to lig ht p hy sic a l e xer tio n, tha t th e re is “ me dic a l im

pr ov e me nt. ” Th e Com mis sio ne r a rgue s, in h is b r ie f

, th a t D r . H e r

n an d e z’ s o p in io n “ th a t c la im an t’ s p h y s ic a l im p a ir me n ts d o n o t limi t her ability to work,” not c ontradicte d by any evidenc e fr om a treating or examining source , constitutes substantial evidence in support of the AL J ’s dec ision. (Appellee’ s Br ief a t 20). We disag ree . The re liance of the Commiss i o n er a

nd the AL J on Dr. He rnande z’s
con c lu s io n is f

la w e d f o r a v e r y s im p le r e a s o n . A r e v ie w o f th e c o n s u lt a ti o n r e qu e s t s e n t to Dr. Her nandez indicates phy sical disorder s of “a sthma, TB, vision, stomach.” No m ention is made of Kenne dy ’s obesity

and no evide nce a

ppear s in the rec ord sug g esting that Dr. He rnande z evaluated the e ff e c ts o f h e r o be sity on he r phy sic a l fun c tio nin g . F ur the rm or e , a s th e Com mis sio ne r c or re c tly argues, a me re dia g nosis of obesity does not establish either the condition’s sever ity or its effe ct on Kenne dy ’s func tional limi tations.

Be cause the re cord c ontains no evidenc e of improve ment in phy sical func tioning related to Kenne dy ’s obesity , both parties foc us their ar g uments on Ke n n ed y ’s weight at va rious po int s si nc e the pr ior de c isi on and on wh e the r SSR 02- 1P, 20 00 WL 62 80 49 (S .S. A. ), a pp lie s to thi s
case . Kenne dy argues t hat S SR 02-1P dictates a finding that there ha s been no me dical improveme nt in her obe sity

since the prior decision. The Com missioner, on the ot her hand, argues t hat S SR 02- 4 1P h a s n o a

pp lic atio n to this ca se but rathe r ap pli e s only to ca se s whe re the c la ima nt w a s p re vio us lyNo. 06-6582

Kennedy v. Astrue

The Commissioner deleted listing 9.09 e ffe ctive Oc tober 25, 1999. The listi ng was met 5 by a cla imant with weig ht equal to or g reater than se t forth in cer tain tables (100 pe rce nt above desired le vel) a

nd arthritis in any

weig ht bear ing joint, hy

perte nsion with diastoli c blood pre ssure persistently

in excess of 100 mm. Hg , history of cong estive hea

rt failure , chronic venous insufficienc y

or re spiratory

disease w ith hy

pox emia. 13 found disabled unde r t he now de leted listing 9.09. Ke nnedy was not found disable d under listing 9.09. 5 We need not dec ide t he reac h of SSR 02-1P for the pur poses of this appea l. I t is for
a more basic re ason that we find that no substantial evidence supports the dec ision of the AL J that imp ro ve d p hy sic a l f

un c tio nin g ha s b e e n e sta

bli sh e d in thi s c a se . T his re cord co nta ins no thi ngto indicate that a

ny eff ort was made to determine wh at , i f an y , eff ect Ke nnedy ’s obesity

has on her
curr ent level of phy sical func tioning and no c omparison was ma de of K ennedy ’s impairments at the time of the re view and those prese nt at the time of the prior deter mination. The Commis sioner
c on c e de s th a t e va luatio n o f o be sity re qu ir e s “an indi vid ua lize d ass e ssm e nt of

the imp a c t of

ob e sity on an individual’s functioning ,” and that obesity is “proper ly

assessed by

its actual impact on other sy stems throug h incre ased f unctional limitation.” (Appellee ’s B rief at 18). This is exactly what wa s not done in this case.

Beca us e thi s is a

c a se wh ic h r e qu ir e s a

sh ow ingof

c ha ng e d c ir c ums tanc e s ( i.e. , medical improve ment) in order to displace e arlier finding s, Drummond v . Commissioner of Social Se c ur ity , 126 F.3d 837, 842 (6th Cir. 1997) (holding t hat “when t he C ommissi oner ha s made a final de c isi on c on cer nin g a c la ima nt’ s e nti tle me nt t o b e ne fi ts, the Com mis sio ne r i s b ound by thi s deter mination absent chang ed circumstance s”), a compar ison betwee n circ umstances e x isting at theNo. 06-6582

Kennedy v. Astrue

14 time of the prior de cision and circumstance s exis ting at the t ime of t he review is necessar y . When the cessation of benef

its is the issue, the Commi ssioner is not to make a new medical de termination but rather is to determine whe ther ther e has be en “me dical improveme nt,” ( i.e. , a dec rea s e i n the
sever ity of impairment). 20 C.F .R. § 416.994(b)(1) (i). The require d compar ison simpl y was not made in this case
. CO NC LU SION

Havingfoun d

th a t s u b s ta nti a l e v id e n c e d o e s n ot support the Commi ssioner’s de cision in t his c a se , w e mus t th e n d e te rm ine the natur e of the re mand
. Ke nn e dy se e ks a re mand of the c a se to the Commi ssioner for an award of continuing benef its. The Court can reve rse a decision of the Commi ssioner and immediate ly awa rd bene fits only

if all essential factual iss ues have bee n resolved and the r ecor d adequately establishes a plaintiff’s entitlement to bene fits. Fa uc he r v . S e c re tar y , 17 F .3 d 1 71 , 1 76 (6 th C ir . 1 99 4) ; Abbott v. Sullivan , 905 F.2d 918, 927 ( 6th Cir
. 1 9 9 0 ). A judicial
awa rd of be nefits is proper

only wher e the pr oof of disability is overwhe lming or where the proof of disability

is strong a

nd evidenc e to t he contrary is lacking
. Mowery v . Hec kler , 771 F.2d 966, 973 (6th Cir. 1 9 8 5 ). On the other hand, 42 U.S.C. § 405(g ) g ives the cour t the power

to remand f

or a rehe aring , and the c ourt is obliged to do so if a ll essential fac tual issues have not y et bee n resolved. Ne wk irk v . S ha lal a , 25 F.3d 316, 318 ( 6th Cir. 1994). The que sti o n o f whether to re mand to the district court for an immediate a

war d of benef its or to remand for

further fac t finding is a c lose one in this case . On t h e o n e h an d, the ultimate bur den is on the Commi ssioner in te rmination proce eding s and we ha v e f o u n dthatNo. 06-6582

Kennedy v. Astrue

15 su bs tanti a l e vid e nc e do e s n ot s up po rt the te rm inatio n. On th e oth e r h and , w hil e the re is s ome evidenc e in this case of som e medical improvement i n Kenne dy ’s ps y cholog ical impairment in that she would “a

ppear to be better

suite d fo r a medium to l ower stress work e nvironment,” ther e wa s
n o co m p arison of prior and c urre nt medical evide nce a s require d by the law a

nd there was no
e v i d e n c e c o n c e r

n i n g h o wK e n n e dy’ s o b e s i ty a f f e c t s h e r p h ys i c a l f

un c t i o n a l c a

p a c i ty. I n th is termin a tio n o f b e ne fi ts c a se , it wa s in c umb e nt u

po n th e Commis sio ne r t o provi d e e v i d en ce o f m ed i ca l i mp ro v em en tan d t o d ev el o p th e r ec o rdat th e e v i d en t i ary h ea ri n g b efore the AL J . He f

ailed to do so. Be cause evidenc e of medical improvement is lacking in the record, we
see no r eason to re mand for f urther f actua l development. We t he re fo re REV ERS E the jud g me nt o f t he di st ric t c ourt

and REM AN D w ith ins tr uc tio ns to t

he dis tr ic t c ourt

to r e mand

the c a se fo r a

n a wa rd of c on tin uin g be ne fi ts.