DocketNumber： 94-2168
Filed Date： 6/13/1995
Status： Precedential
Modified Date： 9/21/2015
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[NOT FOR PUBLICATION]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. ________
-3-