PER CURIAM:
Cornelius Washington appeals the district court's judgment affirming the Commissioner of Social Security's (the "Commissioner") denial of his application for disability insurance benefits and supplemental security income. On appeal, Mr. Washington primarily argues that the Appeals Council erred when it refused to consider additional evidence he submitted. After careful consideration, we hold that the Appeals Council committed legal error when it failed to consider materials from Dr. Wilson, a psychologist who examined Mr. Washington; reverse the district court's judgment; and remand to the district court with instructions to remand to the Commissioner.
Mr. Washington applied for disability insurance benefits and supplemental security income with the Social Security Administration. In his applications, Mr. Washington asserted that he was unable to work and entitled to benefits because he suffered from bipolar disorder-type 2, impulse control disorder, and asthma. After the Commissioner denied his applications, Mr. Washington requested and received a hearing before an administrative law judge ("ALJ").
In December 2011, the ALJ determined that Mr. Washington was not disabled within the meaning of the Social Security Act. The ALJ used the regulations' five-step, sequential evaluation process to determine whether Mr. Washington was disabled. See 20 C.F.R. § 416.920(a)(4).
Mr. Washington requested that the Appeals Council review the ALJ's decision denying benefits and submitted additional evidence to support his disability claim. The new evidence included materials from Dr. Wilson, a licensed psychologist who examined Mr. Washington; Dr. Tulao, a psychiatrist who treated him; and treatment records from CED Mental Health Center where he received mental health treatment. Mr. Washington argued to the Appeals Council that, considering this new evidence, he was disabled and entitled to benefits. He also asserted that the ALJ failed to state adequate reasons for finding him not credible.
Dr. Wilson opined that given the combined effect of Mr. Washington's mental disturbances and cognitive limitations, "it is highly unlikely that he will be able to maintain any type of job" because of difficulties "with the social and the task and problem solving aspects of any job." Psychological Evaluation at 4 (Doc. 6-7).
Along with his report, Dr. Wilson submitted a Mental Health Source Statement, rating Mr. Washington's degree of limitation with respect to specific tasks related to (1) understanding and memory, (2) sustained concentration and persistence, (3) social interaction, and (4) adaptation. In
Dr. Tulao, who treated Mr. Washington from September 2010 through December 2011, opined that Mr. Washington was disabled. But he could not identify the date of onset of Mr. Washington's disability or the expected duration of the disability and never identified a diagnosis. He listed Mr. Washington's symptoms as "fatigue, diminished ability to think or concentrate, flight of ideas or subjective experience that thoughts are racing, and attention too easily drawn to unimportant or irrelevant external stimuli" and also identified the medications that he had prescribed to Mr. Washington and the side effects of those medications. Social Security Disability Questionnaire at 1 (Doc. 6-7).
The Appeals Council denied Mr. Washington's request for review, finding no reason to review the ALJ's decision. In reaching this decision, the Appeals Council considered the treatment records from CED Mental Health Center but not the materials from Dr. Wilson and Dr. Tualo. The Appeals Council explained that it refused to consider the additional evidence from Dr. Wilson and Dr. Tulao because their opinions concerned a later time period and were immaterial to whether Mr. Washington was disabled on or before the date of the ALJ's decision.
Mr. Washington then filed a complaint in the district court, seeking judicial review of the Appeals Council's decision refusing to consider the evidence from Dr. Wilson and Dr. Tulao, as well as the Commissioner's denial of benefits. The district court affirmed, concluding that the Appeals Council properly excluded Dr. Wilson's opinions because they did not relate to the period on or before the ALJ's decision and Dr. Tulao's opinions because they were immaterial.
Mr. Washington argues that the Appeals Council committed legal error when it refused to consider evidence from Dr. Wilson and Dr. Tulao. We reverse the district court's judgment in favor of the Commissioner because the Appeals Council's refusal to consider Dr. Wilson's opinions was legal error. We remand with instructions that the district court remand the case to the Commissioner to consider the new evidence.
"With a few exceptions, the claimant is allowed to present new evidence at each stage of this administrative process," including before the Appeals Council. Ingram v. Comm'r of Soc., Sec. Admin., 496 F.3d 1253, 1261 (11th Cir.2007). The Appeals Council has the discretion not to review the ALJ's denial of benefits. See 20 C.F.R. § 416.1470(b). But the Appeals Council "must consider new, material, and chronologically relevant evidence" that the claimant submits. Ingram, 496 F.3d at 1261; see also 20 C.F.R. §§ 404.970(b), 416.1470(b).
"When the Appeals Council refuses to consider new evidence submitted to it and denies review, that decision is . . . subject to judicial review. . . ." Keeton v. Dep't of Health & Human Servs., 21 F.3d 1064, 1066 (11th Cir.1994). The standard that federal courts apply when reviewing the Appeals Council's refusal to consider
The Appeals Council committed legal error when it refused to consider Dr. Wilson's opinions. Although the Appeals Council refused to consider the materials because they were not chronologically relevant, the Commissioner now argues that the materials were also immaterial. We disagree.
We begin with materiality. Dr. Wilson's opinions are material because, if accepted, "there is a reasonable possibility" that they "would change the administrative result." Hyde v. Bowen, 823 F.2d 456, 459 (11th Cir.1987). More specifically, there is a reasonable possibility that Dr. Wilson's opinions could establish that Mr. Washington had "an impairment[] that meets or equals" listing 12.04 because he experienced at least marked difficulties in maintaining social functioning and in maintaining concentration, persistence, or pace. 20 C.F.R. § 404.1520(a)(4)(iii). Dr. Wilson's report explains that (1) Mr. Washington experienced auditory hallucinations and mood swings and was unable to control his thoughts, and (2) testing showed that he had significant cognitive defects, could barely read, and possessed verbal skills in the lower borderline or upper end of the intellectually disabled range. Based on these findings, Dr. Wilson concluded that Mr. Washington would have difficulties with the "social and the task and problem solving aspects of any job." Psychological Evaluation at 4 (Doc. 6-7). In the Mental Health Source Statement, Dr. Wilson opined that Mr. Washington experienced extreme (that is, more than marked) limitations in almost all categories relating to social interaction, sustaining concentration and persistence, and adaptation. Considering this evidence, a factfinder could reasonably conclude that Mr. Washington had at least marked difficulties in maintaining social functions, concentration, and persistence, and, thus, his impairment met listing 12.04.
The Commissioner argues that Dr. Wilson's opinions could not have changed the
The Commissioner also asserts that Dr. Wilson's opinions are "wholly inconsistent" with treatment notes from CED Mental Health Center, where Mr. Washington received mental health treatment, showing that he exhibited normal behavior and a willingness to learn. Appellee's Br. at 22. But the treatment notes reflect that Mr. Washington reported regularly experiencing hallucinations, hearing voices, having difficulty concentrating, being easily distracted, and struggling with anger. These records are consistent with and, in fact, support Dr. Wilson's opinions.
The opinions contained in Dr. Wilson's materials—including that Mr. Washington had extreme limitations in social interaction, sustained concentration, and persistence—are chronologically relevant even though Dr. Wilson examined him several months after the ALJ's decision. Dr. Wilson based his opinions on the combined effects of Mr. Washington's hallucinations and limited cognitive abilities. Dr. Wilson understood that Mr. Washington had experienced hallucinations during the time period prior to the ALJ's decision because (1) Mr. Washington told Dr. Wilson that he had experienced hallucinations throughout his life, and (2) Dr. Wilson reviewed Mr. Washington's mental health treatment records from the period before the ALJ's decision reflecting that he repeatedly reported experiencing auditory and visual hallucinations. Further, Dr. Wilson's opinions about Mr. Washington's cognitive defects, including that his verbal skills were in the range of borderline or intellectual disability, relate back to the period before the ALJ's decision.
There is no assertion or evidence here that Mr. Washington's cognitive skills declined in the period following the ALJ's decision. Although Dr. Wilson never explicitly stated that his opinions related back to the date of the ALJ's decision, we have recognized that medical opinions based on treatment occurring after the date of the ALJ's decision may be chronologically relevant. See Boyd v. Heckler,
Because Dr. Wilson's opinions are new, material, and chronologically relevant evidence, the Appeals Council was required to consider them.
For the reasons set forth above, the district court's judgment is reversed. This case is remanded to the district court with instructions to remand it to the Commissioner for consideration of the new medical evidence.