## Facts

- Rachele Russ applied for Disability Insurance Benefits and Supplemental Security Income in 1999, alleging disability primarily due to extreme obesity and related limitations.
- The agency denied the claims initially and on reconsideration.
- After a hearing, the ALJ found Russ had an impairment of disabling severity but denied benefits on the ground that she failed, without good reason, to follow “prescribed treatment” that could restore her ability to work.
- The ALJ relied chiefly on a treating physician’s interrogatory responses stating the physician had “urged” Russ to continue losing weight to improve her condition.
- The record did not show a specific, medically supervised weight-loss regimen with defined instructions or parameters.
- The Appeals Council denied review, making the ALJ’s decision the Commissioner’s final decision.
- Russ sought judicial review under 42 U.S.C. § 405(g) in federal district court.

## Issues

1. Whether substantial evidence supported the ALJ’s finding that Russ failed to follow “prescribed treatment” when the physician’s statements amounted to general advice to lose weight rather than a clearly prescribed regimen.
2. Whether the ALJ applied the correct legal standard for denying an otherwise valid disability claim based on noncompliance with prescribed treatment.

## Decision

- The district court reversed the Commissioner’s denial of benefits and remanded for further proceedings.
- The court held the noncompliance rationale was not supported by substantial evidence and reflected legal error.
- The court concluded the ALJ treated general encouragement to lose weight as “prescribed treatment” without record support for a specific prescription or for the required findings regarding restoration of ability to work and lack of good reason.

## Legal Principles

- On review under 42 U.S.C. § 405(g), the Commissioner’s factual findings are upheld if supported by substantial evidence, but legal standards are reviewed for correctness.
- Benefits may be denied for failure to follow prescribed treatment only if (1) a physician clearly prescribed the treatment, (2) the treatment is reasonably expected to restore the ability to work, and (3) the claimant failed to follow it without good reason.
- General medical advice or encouragement (including recommendations to diet or lose weight) does not, without more, constitute “prescribed treatment” for purposes of the noncompliance regulations.

## Conclusion

The court set aside the denial because the ALJ improperly relied on generalized weight-loss advice as “prescribed treatment” and failed to support the noncompliance finding under the governing regulatory requirements, requiring remand for reconsideration under the correct standard.


Russ v. Barnhart, 363 F. Supp. 2d 1345 (M.D. Fla. 2005)