3:21-cv-00720
M.D. Fla.Nov 16, 2022Background
- Plaintiff applied for Period of Disability, Disability Insurance Benefits, and SSI; ALJ denied benefits in a decision dated December 16, 2020, finding no disability from the December 8, 2019 onset date through the decision.
- In December 2019 Plaintiff underwent a right midfoot amputation after ER admission for gangrene, sepsis, and diabetes-related complications and received ongoing follow-up care for wound/incision healing and mobility limitations.
- At the administrative hearing Plaintiff testified to persistent pain from a chronic blister/ulcer, balance and walking difficulties, use of a cane, need to elevate the foot, and intolerance of his shoe/brace; the ALJ discounted this testimony and found an RFC for sedentary work with limitations.
- After the ALJ decision Plaintiff submitted two new treating-podiatrist notes (Jan. 29, 2021 and Mar. 19, 2021) to the Appeals Council documenting a chronic non-pressure ulcer, problems tolerating the brace/shoe, and a recommendation of no weightbearing.
- The Appeals Council declined review, finding the records did not relate to the period at issue; the district court reviewed de novo and held the records were new, chronologically relevant, and material, and therefore reversed and remanded under sentence four of 42 U.S.C. § 405(g).
Issues
| Issue | Plaintiff's Argument | Defendant's Argument | Held |
|---|---|---|---|
| Whether the Appeals Council erred in not remanding for new evidence | The Jan. 29 and Mar. 19, 2021 treating notes are new, relate back to the period before the ALJ decision, and are material | Records post-date the ALJ decision and therefore do not relate to the period at issue | Court reversed and remanded: records are new, chronologically relevant, and material; remand to consider notes and reconsider RFC |
| Whether ALJ properly discredited Plaintiff's symptom testimony | ALJ improperly discounted testimony about pain, cane use, and need to elevate foot | ALJ relied on medical records showing good response to treatment and ambulation with brace without assistive device | Not addressed on the merits (court remanded because new evidence may change the analysis) |
| Whether Commissioner met burden to identify other work in national economy | Vocational evidence insufficient given limitations | Commissioner relied on vocational testimony and RFC to show other work exists | Not addressed on the merits (court remanded) |
Key Cases Cited
- Winschel v. Comm’r of Soc. Sec., 631 F.3d 1176 (11th Cir. 2011) (sets substantial-evidence standard and scope of appellate review)
- Lewis v. Barnhart, 285 F.3d 1329 (11th Cir. 2002) (de novo review of legal conclusions)
- Pupo v. Comm’r of Soc. Sec., 17 F.4th 1054 (11th Cir. 2021) (Appeals Council must consider additional medical records when chronologically relevant)
- Washington v. Comm’r of Soc. Sec., 806 F.3d 1317 (11th Cir. 2015) (post-decision medical evidence may be chronologically relevant and material if it relates back)
- Hyde v. Bowen, 823 F.2d 456 (11th Cir. 1987) (materiality standard: reasonable possibility that new evidence would change the outcome)
