Amber Ashley v. Commissioner, Social Security Administration
707 F. App'x 939
| 11th Cir. | 2017Background
- Ashley applied for DIB and SSI alleging disability from a September 29, 2010 car accident; she underwent left hip/acetabular fixation (2010) and left total hip arthroplasty (2011) and reported chronic left hip/leg pain and limitations.
- The ALJ found severe orthopedic impairments but determined Ashley retained a sedentary RFC (limited sitting/standing intervals consistent with consultative examiner Dr. Iyer) and denied benefits through January 23, 2013 because jobs existed she could perform.
- Ashley submitted additional medical records to the Appeals Council, many dated after the ALJ’s decision documenting new/worsening hematologic conditions (anemia, pancytopenia, myelodysplastic-type findings) with transfusions and infusions beginning in mid–late 2013.
- The Appeals Council placed some post-decision records into the administrative record and explicitly declined to consider other later records as not chronologically relevant to the period on or before the ALJ decision; several specific records (Drs. Thomasson, Teschner, and Warren) were not in the administrative record and their status was unclear.
- The district court denied remand and affirmed the Commissioner; it placed some of the missing records into the district-court record but denied a sixth-sentence remand and denied a Rule 59(e) motion. The Eleventh Circuit affirmed: the Appeals Council reasonably excluded post-decision hematologic treatment records as not chronologically relevant, and the additional records did not warrant remand.
Issues
| Issue | Plaintiff's Argument | Defendant's Argument | Held |
|---|---|---|---|
| Whether the Appeals Council erred by not considering post-ALJ medical records | Appeals Council failed to determine chronological relevance for all post-decision records and thus unlawfully omitted material evidence | Appeals Council reviewed or “looked at” records and properly excluded those relating to treatment after the ALJ decision as not chronologically relevant | Affirmed: Appeals Council permissibly declined to consider most post-decision hematologic records as not chronologically relevant |
| Whether post-decision hematologic records were chronologically relevant/material | Records documenting anemia/pancytopenia and transfusions relate back and could change outcome | Records document new/worsening conditions beginning after the ALJ decision and thus do not relate to period under review | Affirmed: records reflect deterioration after the decision and are not chronologically relevant or material to the period through Jan 23, 2013 |
| Whether the district court should have ordered a sixth-sentence remand for missing records (Drs. Thomasson, Teschner, Warren) | These records are new, noncumulative, material, and good cause exists for their absence at the agency level | Records are cumulative, not material, or not chronologically probative; Dr. Warren’s opinion aligns with existing consultative findings | Affirmed: Thomasson/Teschner cumulative or not chronologically relevant; Warren not material because consistent with prior consultative opinion and ALJ RFC |
| Whether Washington v. SSA required relief or Rule 59(e) relief | Washington requires Appeals Council to assess chronological relevance of post-decision opinions; Rule 59(e) relief appropriate given new precedent | Washington distinguishable; claimant cannot relitigate through Rule 59(e); precedent does not alter outcome here | Affirmed: Washington distinguishable; no basis to alter judgment or remand under Rule 59(e) |
Key Cases Cited
- Washington v. Social Security Administration, 806 F.3d 1317 (11th Cir. 2015) (post-decision medical opinions may be chronologically relevant in specific circumstances)
- Ingram v. Comm’r of Social Security Admin., 496 F.3d 1253 (11th Cir. 2007) (Appeals Council must consider new, material, chronologically relevant evidence)
- Hyde v. Bowen, 823 F.2d 456 (11th Cir. 1987) (materiality standard: reasonable possibility new evidence would change outcome)
- Caulder v. Bowen, 791 F.2d 872 (11th Cir. 1986) (new evidence must not be merely cumulative)
- Wilson v. Apfel, 179 F.3d 1276 (11th Cir. 1999) (deterioration after the relevant period may support a new application but typically does not prove disability during the earlier review period)
- Hargress v. Social Security Admin., 874 F.3d 1284 (11th Cir. 2017) (Appeals Council may decline post-decision evidence as about a later time; explains limits of Washington)
- Cherry v. Heckler, 760 F.2d 1186 (11th Cir. 1985) (reviewing court generally limited to certified administrative record)
- Milano v. Bowen, 809 F.2d 763 (11th Cir. 1987) (treating evidence first considered by district court as submitted there when Appeals Council refused it)
- Vega v. Comm’r of Social Security, 265 F.3d 1214 (11th Cir. 2001) (standards for remand based on new evidence)
- Hunter v. Social Security Admin., 808 F.3d 818 (11th Cir. 2015) (elements required for a sixth-sentence remand)