Court Opinion

ID: 2963425
Source: CourtListenerOpinion
Date Created: 2015-09-21 21:09:34.215028+00
Date Added: 2024-06-11T15:02:00.226803
License: Public Domain

USCA1 Opinion

	

          June 13, 1995
                                [NOT FOR PUBLICATION]

                            UNITED STATES COURT OF APPEALS
                                FOR THE FIRST CIRCUIT

                        
                                 ____________________

        No. 94-2168 

                                  LORRAINE GRISWOLD,

                                Plaintiff, Appellant,

                                          v.

                       SECRETARY OF HEALTH AND HUMAN SERVICES,

                                 Defendant, Appellee.

                                 ____________________

                     APPEAL FROM THE UNITED STATES DISTRICT COURT

                          FOR THE DISTRICT OF MASSACHUSETTS

                 [Hon. Frank H. Freedman, Senior U.S. District Judge]
                                          __________________________

                                 ____________________

                                        Before

                                Cyr, Boudin and Stahl,
                                   Circuit Judges.
                                   ______________

                                 ____________________

            Sandra Susse on brief for appellant.
            ____________
            Donald  K.  Stern,  United  States  Attorney,  Karen  L.  Goodwin,
            _________________                              __________________
        Assistant  United  States Attorney,  and  Jessie  M. Klyce,  Assistant
                                                  ________________
        Regional Counsel,  Department of Health  and Human Services,  on brief
        for appellee.

                                 ____________________

                                 ____________________

                      Per Curiam.  We have carefully reviewed the  record
                      __________

            and the briefs of the parties and agree with the  decision of

            the district court  for essentially the reasons stated in its

            Memorandum and Order, dated  September 8, 1994.  We  add only

            the following comment.

                      Aside from taking Pamelor, claimant did not undergo

            any treatment for her depression.  She maintains that she had

            limited insight into her condition and, thus, did not realize

            the need for psychotherapy.  The record indicates  otherwise.

            In December  1988, claimant informed  Dr. J. Stephen  Fink, a

            consulting  neurologist,  that she  was  scheduled  to see  a

            psychological  counselor.  When she next saw Dr. Fink in July

            1989, she stated that she never had pursued treatment for her

            depression.   This reveals an awareness on claimant's part of

            the appropriateness of counseling.

                      Further, personnel at Baystate Medical Center twice

            recommended that claimant undergo  psychotherapy.  The  first

            occasion  was  in  November  1990  after  claimant  expressed

            suicidal ideation.  The second was in July 1991, but claimant

            refused  the referral.  Finally, Dr.  Michael Bohnert, one of

            the examining consultants,  indicated that  psychotherapeutic

            intervention might significantly improve claimant's prognosis

            and,  in  a  related vein,  Dr.  Elizabeth  P.  Hess, another

            examiner,  opined that  claimant  needed  a  more  aggressive

            course of medication.

                      As we noted in Tsarelka v.  Secretary of Health and
                                     ________     _______________________

            Human  Services, 842 F.2d  529 (1st Cir.  1988) (per curiam),
            _______________

            the Social Security regulations  require a claimant to follow

            restorative treatment  prescribed by  her physician.   Id. at
                                                                   ___

            534 (citing 20 C.F.R.   404.1530(a)).  The failure to observe

            prescribed treatment without good cause can lead to a finding

            of  not  disabled.   Id.  (citing 20  C.F.R.    404.1530(b)).
                                 ___

            Indeed, gaps in the  medical record which indicate a  lack of

            treatment  are  "evidence"  for  purposes  of the  disability

            determination.   Irlanda-Ortiz  v.  Secretary of  Health  and
                             _____________      _________________________

            Human  Services,  955 F.2d  765,  769  (1st  Cir. 1991)  (per
            _______________

            curiam).  

                      Thus,   claimant's   disregard   of  the   specific

            referrals to psychotherapy,  as well as the  lack of evidence

            to indicate  that her  medication ever was  re-evaluated, are

            proper considerations.  Based on this record, then, we cannot

            say  that the Secretary of Health and Human Services erred in

            citing the lack of  treatment as one  of the reasons for  the

            determination  that  claimant  was  not disabled.    See  id.
                                                                 ___  ___

            (conflicts in the evidence  are for the Secretary).   In this

            case, we think, the absence of treatment is dispositive.

                      The judgment of the district court is affirmed.
                                                            ________

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