Eleventh Circuit Finds Appeals Council of Social Security Administration Committed a Legal Error by Failing to Consider New Medical Evidence

In Washington v. Social Security Administration, 806 F.3d 1317 (11th Cir. 2015), the Eleventh Circuit reversed the district court’s decision to affirm the Social Security Administration’s denial of disability benefits and remanded the case for further proceedings.

Mr. Washington applied for disability benefits, asserting that he was unable to work because he suffered from bipolar disorder, impulse control, and asthma. The Social Security Administration (SSA) denied his application. Mr. Washington subsequently requested a hearing before an administrative law judge (ALJ). The ALJ heard Mr. Washington’s case in December of 2011 and determined that Mr. Washington was not disabled because he did not meet any listed impairments and there were a significant number of jobs in the national economy he could perform.

Mr. Washington appealed his case to the SSA Appeals Council, and included new medical evidence from Dr. Wilson, a licensed psychologist. Dr. Wilson opined that it was highly unlikely that Mr. Washington could maintain a job because he suffered from mental disturbances and cognitive limitations. Dr. Wilson’s opinion was based on an evaluation in July of 2012, approximately seven months after the ALJ’s decision. Consequently, the Appeals Council denied Mr. Washington’s request for review after determining that Dr. Wilson’s report was not chronologically relevant.

Mr. Washington filed a complaint with the United States District Court for the Northern District of Alabama, seeking review of the Appeals Council’s decision not to consider the new evidence from Dr. Wilson. The district court affirmed the Appeals Council, and Mr. Washington appealed to the Eleventh Circuit.

In a question of first impression, the Eleventh Circuit first held that refusal to consider new evidence is a question of law, thus deserving of de novo review. The court then noted that the Appeals Council “must consider new, material, and chronologically relevant evidence.” Id. at 1320 (citations and quotations omitted). With respect to materiality, the court held that Dr. Wilson’s opinion was material because there was a reasonable possibility that Dr. Wilson’s opinion would change the outcome of Mr. Washington’s case. Next, the court held that Dr. Wilson’s report was chronologically relevant because his opinion about Mr. Washington’s cognitive abilities pertained to the time period before Mr. Washington’s hearing before the ALJ.

Thus, the court held that Dr. Wilson’s report met the requirements of “new, material, and chronologically relevant” and the Appeals Council committed a legal error by not considering it. Accordingly, the Eleventh Circuit reversed the district court’s affirmance of the Appeals Council and remanded Mr. Washington’s case to be reconsidered by the SSA Commissioner.

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