Alicia Stone v. Social Security Administration, Commissioner
658 F. App'x 551
| 11th Cir. | 2016Background
- Alicia Stone applied for Social Security disability insurance; ALJ denied benefits on October 26, 2012.
- While her appeal to the Appeals Council was pending, Stone submitted new CED Mental Health Center records dated December 14, 2012–June 27, 2013 ("CED Records").
- Stone argued the Appeals Council erred by refusing to consider the CED Records because they would show her depression was a severe impairment and related back to the ALJ’s decision period.
- The CED Records are not part of the certified administrative record before this Court; review is limited to Stone’s summary of those records.
- The ALJ’s record already included evidence that Stone had depression, and a consultative reviewer (Dr. Estock) opined her depression was controlled by medication and not severely limiting.
- Records from Holistic Pain Management in 2012 indicated Stone denied depression symptoms during several visits, undermining a clear showing that the CED Records related back to the ALJ’s decision date.
Issues
| Issue | Plaintiff's Argument | Defendant's Argument | Held |
|---|---|---|---|
| Whether Appeals Council erred by refusing to consider post-ALJ medical records | CED Records are new, material, and chronologically relevant and would show depression was severe | Appeals Council permissibly excluded records dated after the ALJ decision because they did not relate back to the relevant period or were cumulative | No error: Appeals Council properly declined to consider the CED Records |
| Whether CED Records are chronologically relevant | "Recurrent" diagnosis and statement of 10-year history show condition existed before ALJ decision | Summaries contain only post-decision complaints/diagnoses and no indication provider reviewed prior records | Not chronologically relevant: summaries do not show they relate to period on/before ALJ decision |
| Whether CED Records are material (could change outcome) | Records would corroborate and substantiate prior evidence of depression | Evidence before ALJ already showed depression and was considered; CED statements are cumulative or show post-decision worsening | Not material: no reasonable possibility the CED summaries would change the administrative result |
| Whether Washington precedent requires remand when Appeals Council excludes post-decision evidence | Washington mandates consideration where records can relate back and no evidence of decline exists | Washington is distinguishable because here records indicate post-decision worsening and show no review of prior records | Washington distinguished; no remand required |
Key Cases Cited
- Washington v. Social Security Admin., Comm’r, 806 F.3d 1317 (11th Cir. 2015) (new evidence must be new, material, and chronologically relevant; post-decision exams may relate back in certain circumstances)
- Milano v. Bowen, 809 F.2d 763 (11th Cir. 1987) (evidence is material if there is a reasonable possibility it would change the administrative result)
- Cherry v. Heckler, 760 F.2d 1186 (11th Cir. 1985) (reviewing court is limited to the certified administrative record)
- Access Now, Inc. v. Southwest Airlines Co., 385 F.3d 1324 (11th Cir. 2004) (arguments not raised are deemed abandoned)