Cornelius Washington v. Social Security Administration, Commissioner
806 F.3d 1317
11th Cir.2015Background
- Cornelius Washington applied for SSI and DIB alleging bipolar II, impulse control disorder, and asthma; an ALJ denied benefits in Dec 2011 after a hearing, finding he could perform substantial work.
- ALJ found severe bipolar disorder but concluded Washington did not meet Listing 12.04 (only mild/moderate limits) and had no past relevant work; vocational testimony identified available jobs.
- Washington submitted additional evidence to the Appeals Council: a July 2012 psychological evaluation and Mental Health Source Statement by Dr. Wilson (examining psychologist), a treating psychiatrist’s questionnaire from Dr. Tulao, and CED treatment records.
- Dr. Wilson reported severe cognitive deficits, ongoing auditory hallucinations, and extreme limitations in most areas of social interaction, concentration/persistence, and adaptation; he concluded Washington was unlikely to maintain any job.
- The Appeals Council considered the CED records but declined to consider Dr. Wilson’s and Dr. Tulao’s materials, saying they concerned a later time period and were immaterial; the district court affirmed. Washington appealed.
Issues
| Issue | Plaintiff's Argument | Defendant's Argument | Held |
|---|---|---|---|
| Whether the Appeals Council erred by refusing to consider evidence submitted after the ALJ decision | Washington: Appeals Council must consider new, material, chronologically relevant evidence (Dr. Wilson, Dr. Tulao) submitted to it | Commissioner: Evidence not chronologically relevant or material; contradictory to existing record so would not change result | Court: Appeals Council committed legal error by refusing to consider Dr. Wilson’s evidence; remand required |
| Materiality of Dr. Wilson’s report | Dr. Wilson’s opinions could reasonably change the outcome by supporting meeting Listing 12.04 (marked difficulties in social function and concentration/persistence) | Commissioner: Dr. Wilson conflicts with other examiners and treatment notes; would be discounted | Court: Dr. Wilson’s opinions are material because a factfinder could credit them and they could change result |
| Chronological relevance of Dr. Wilson’s report | Washington: Although performed after ALJ decision, report relates back to the relevant period (based on history and prior treatment records) | Commissioner: Examination post-dates ALJ decision and thus not chronologically relevant | Court: Chronologically relevant — opinions relate to pre-ALJ period and thus Appeals Council had to consider them |
| Status of Dr. Tulao’s questionnaire | Washington: Submitted as additional evidence supportive of disability | Commissioner: Questionnaire is cumulative/immaterial and contains no new medical findings or diagnoses | Court: Dr. Tulao’s questionnaire is not new/material; Appeals Council did not err in excluding it |
Key Cases Cited
- Ingram v. Comm’r of Soc. Sec. Admin., 496 F.3d 1253 (11th Cir. 2007) (claimant may present new evidence at each administrative stage; Appeals Council must consider new, material, chronologically relevant evidence)
- Keeton v. Dep’t of Health & Human Servs., 21 F.3d 1064 (11th Cir. 1994) (Appeals Council refusals to consider new evidence are judicially reviewable)
- Threet v. Barnhart, 353 F.3d 1185 (10th Cir. 2003) (whether evidence is new, material, chronologically relevant is a legal question reviewed de novo)
- Farrell v. Astrue, 692 F.3d 767 (7th Cir. 2012) (same principle on de novo review of Appeals Council’s exclusion of evidence)
- Bergmann v. Apfel, 207 F.3d 1065 (8th Cir. 2000) (Appeals Council must consider new, material, chronologically relevant evidence)
- Hyde v. Bowen, 823 F.2d 456 (11th Cir. 1987) (materiality standard: new evidence must have a reasonable possibility of changing the administrative result)
- Boyd v. Heckler, 704 F.2d 1207 (11th Cir. 1983) (post-decision medical evidence can be chronologically relevant and considered)
- Caulder v. Bowen, 791 F.2d 872 (11th Cir. 1986) (cumulative evidence is not "new")
- Lewis v. Callahan, 125 F.3d 1436 (11th Cir. 1997) (physician opinions that a claimant is disabled are legal conclusions reserved to the Commissioner)
- Mitchell v. Comm’r, Soc. Sec. Admin., 771 F.3d 780 (11th Cir. 2014) (when Appeals Council considers new evidence and denies review, it need not provide detailed rationale)