Angel McClain v. Social Security Administration ( 2019 )


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  •            Case: 18-10570   Date Filed: 01/10/2019   Page: 1 of 10
    [DO NOT PUBLISH]
    IN THE UNITED STATES COURT OF APPEALS
    FOR THE ELEVENTH CIRCUIT
    ________________________
    No. 18-10570
    Non-Argument Calendar
    ________________________
    D.C. Docket No. 1:16-cv-00547-MU
    ANGEL MCCLAIN,
    Plaintiff - Appellant,
    versus
    SOCIAL SECURITY ADMINISTRATION,
    Defendant - Appellee.
    ________________________
    Appeal from the United States District Court
    for the Southern District of Alabama
    ________________________
    (January 10, 2019)
    Before JORDAN, JILL PRYOR and HULL, Circuit Judges.
    PER CURIAM:
    Case: 18-10570        Date Filed: 01/10/2019      Page: 2 of 10
    Angela McClain appeals the district court’s order affirming the decision of
    the Commissioner of the Social Security Administration to deny her application for
    disability insurance benefits. After an administrative law judge (“ALJ”)
    determined she was not disabled, McClain sought further review from the Appeals
    Council. McClain submitted additional evidence to the Appeals Council, including
    a psychological examination report. But the Appeals Council refused to consider
    the report on the basis that it was about a later time. On appeal, McClain argues
    that the Appeals Council was required to consider the report. We affirm because
    the Appeals Council properly determined that the report was not chronologically
    relevant.
    I.
    McClain applied for disability insurance benefits, claiming that she was
    disabled due to various physical impairments and anxiety. After her application
    was denied, McClain received a hearing before an ALJ.
    Before the ALJ, McClain testified about her psychological and intellectual
    limitations. 1 She described having problems understanding and remembering
    simple instructions, as well as difficulty concentrating. She also stated that she had
    problems with her nerves and difficulty getting along with other people. McClain
    1
    Because McClain’s arguments on appeal relate only to whether the Appeals Council
    should have considered additional evidence of her psychological and intellectual limitations, we
    discuss only the evidence related to those limitations.
    2
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    explained that she recently started mental health treatment and had been prescribed
    Lorazpam. She found the medication had helped her in interactions with others.
    The ALJ also reviewed McClain’s medical records. These records reflect
    that McClain had been diagnosed with anxiety and prescribed Lorazepam.
    Treatment notes from her physician, Dolores Victoria, indicate that at some
    appointments McClain reported experiencing symptoms of anxiety and depression.
    But at other appointments, she reported no anxiety or depression. Victoria’s notes
    during this period consistently indicate that McClain had an intact memory.
    The medical records also reflect that McClain reported to another physician
    that she was having problems with her nerves. That physician prescribed
    Klonopin.
    McClain saw a therapist twice. The therapist’s intake notes indicate that
    McClain had a depressive mood and long-term memory deficits. The therapist also
    noted that McClain had an appropriate affect, normal orientation, above-average
    intelligence, and average judgment and insight. The therapist diagnosed McClain
    with major depression and post-traumatic stress disorder and recommended that
    she participate in individual therapy. McClain returned for one therapy
    appointment. The therapist noted that McClain was showing good progress and
    could benefit from a mood stabilizer or anti-depressant.
    3
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    The only other evidence before the ALJ related to McClain’s mental health
    or intellectual limitations was the opinion of a state agency psychological
    consultant. After reviewing McClain’s medical records, the consultant opined that
    McClain’s anxiety was not severe and would not impose even moderate limitations
    on her ability to work.
    After considering the evidence and applying the five-step sequential
    evaluation process, the ALJ determined that McClain was not disabled. At the first
    step, the ALJ found that McClain had not engaged in substantial gainful activity
    since the alleged onset of disability date. At the second step, the ALJ concluded
    that she had severe impairments. At the third step, the ALJ found that McClain did
    not have an impairment or combination of impairments that met or medically
    equaled the severity of a listed impairment. The ALJ then assessed McClain’s
    residual functional capacity and found that she was able to perform light work
    subject to certain limitations, including that she could perform only simple tasks,
    occasionally interact with the public, and have only brief and casual contact with
    supervisors and coworkers. At step four, the ALJ found that McClain was unable
    to perform her past relevant work. At step five, the ALJ found that given
    McClain’s age, education, work experience, and residual functional capacity, there
    were jobs that existed in significant numbers in the national economy that she
    could perform.
    4
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    McClain sought review from the Appeals Council. She submitted new
    evidence to the Appeals Council, including materials from psychologist David
    Wilson, who evaluated McClain about 15 months after the ALJ’s decision issued.
    Based on his evaluation and a review of McClain’s mental health records, Wilson
    prepared a psychological evaluation report and a mental health source statement.
    Wilson diagnosed McClain with depression and anxiety and also determined that
    she had borderline intellectual functioning. Wilson further opined that McClain
    had poor mental control and attention, significant problems with short term
    memory and working memory, extremely deficient acquired information, and very
    poor abstract reasoning. Wilson indicated that McClain’s ability to withstand the
    day to day pressures of working was highly impaired. Wilson determined that
    McClain could not understand, remember, or carry out even simple instructions;
    maintain attention, concentration, and pace for at least two hours; sustain an
    ordinary routine without special supervision; or interact appropriately with
    supervisors or co-workers. He opined that she had experienced these limitations
    for at least the past three years.
    McClain also submitted to the Appeals Council records from a licensed
    social worker who provided McClain with counseling services. The social worker
    treated McClain in the period after the ALJ’s decision but before Wilson
    5
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    performed his evaluation. The social worker’s notes reflect that McClain’s
    cognition was within normal limits and her intelligence was average.
    The Appeals Council denied McClain’s request for review.
    The Appeals Council explained that it looked at the material from Wilson but
    concluded that his opinions were about a later time and thus did not affect the
    decision about whether she was disabled in the period before the ALJ’s decision.
    McClain filed an action in federal district court, asking the court to reverse
    the Commissioner’s decision. The magistrate judge issued an order affirming the
    Commissioner’s decision. 2 This is McClain’s appeal.
    II.
    “When the Appeals Council refuses to consider new evidence submitted to it
    and denies review, that decision is subject to judicial review.” Washington v. Soc.
    Sec. Admin., Comm’r, 
    806 F.3d 1317
    , 1320 (11th Cir. 2015) (alteration adopted)
    (internal quotation marks omitted). We review de novo whether the claimant’s
    additional evidence qualifies as “new, material, and chronologically relevant.” 
    Id. 1321
    . (internal quotation marks omitted). “[W]hen the Appeals Council
    erroneously refuses to consider evidence, it commits legal error and remand is
    appropriate.” 
    Id.
    2
    The parties consented to having a magistrate judge decide the case.
    6
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    III.
    A claimant is allowed to present new evidence at each stage of the social
    security administrative process, including before the Appeals Council. 
    20 C.F.R. § 404.900
    (b). The Appeals Council has discretion not to review an ALJ’s denial of
    benefits, but it “must consider new, material, and chronologically relevant
    evidence that the claimant submits.” Washington, 806 F.3d at 1320 (internal
    quotation marks omitted); see 
    20 C.F.R. § 404.970
    (b) (2016). 3 Evidence is
    chronologically relevant if it “relates to the period on or before the date of the
    administrative law judge hearing decision.” 
    20 C.F.R. § 404.970
    (b) (2016). The
    Hearings, Appeals, and Litigation Law Manual for the Social Security
    Administration (“HALLEX”) states that “[a] worsening of the condition or onset of
    a new condition after the date of the hearing decision” is an example of evidence
    that is not related to the period at issue. HALLEX, I-3-3-6(B)(2). Additionally,
    HALLEX provides that “a statement may relate to the period [at issue] . . . when it
    postdates the decision but makes a direct reference to the time period adjudicated
    in the hearing decision.” 
    Id.
    3
    In January 2017, § 404.970 was amended to add a requirement that the claimant show
    good cause for submitting new evidence to the Appeals Council. See Ensuring Program
    Uniformity at the Hearing and Appeals Council Levels of the Administrative Review Process,
    
    91 Fed. Reg. 90,987
     (Dec. 16, 2016). Neither McClain nor the Commissioner contends that this
    amendment, which was implemented after the Appeals Council denied McClain’s request for
    review, applies to this appeal. See Hargress v. Soc. Sec. Admin., Comm’r, 
    883 F.3d 1302
    , 1309
    n.4 (11th Cir. 2018).
    7
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    The Appeals Council is not required to provide a detailed discussion of a
    claimant’s new evidence when denying a request for review. Hargress v. Soc. Sec.
    Admin., Comm’r, 
    883 F.3d 1302
    , 1309 (11th Cir. 2018). It is sufficient for the
    Appeals Council to state that the submitted records are about a later time and,
    therefore, do not affect the decision about whether a claimant was disabled at the
    time of the ALJ hearing. 
    Id.
    McClain argues that the Appeals Council erred when it denied review and
    contends that it should have considered Wilson’s opinions. As an initial matter,
    she contends that the Appeals Council refused to consider Wilson’s records
    without considering whether the records were chronologically relevant. Not so.
    The Appeals Council stated that it had looked at Wilson’s records and determined
    that that they were “about a later time.” Doc. 13 at 7.4 This statement is sufficient
    to indicate that the Appeals Council looked at more than just the dates on the
    records but instead considered the content of Wilson’s opinion and concluded that
    they did not relate to the period on or before the date of the hearing decision.
    Although medical opinions based on treatment occurring after the date of the
    ALJ’s decision may be chronologically relevant, Wilson’s opinion is not
    chronologically relevant. Wilson evaluated McClain more than 14 months after
    the date of the ALJ’s decision and his opinion appears to relate to the worsening of
    4
    Citations in the form “Doc. #” refer to numbered entries on the district court’s docket.
    8
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    a condition or the onset of a new condition after the date of the ALJ’s decision. In
    his evaluation, Wilson opined that McClain had borderline intellectual functioning.
    This opinion must reflect a decline or change in McClain’s intellectual function
    because McClain’s medical records reflect that McClain had normal intellectual
    functioning in the period prior to Wilson’s evaluation. The therapist who treated
    McClain in the period before the ALJ’s decision noted that she had above-average
    intelligence and average judgment and insight. And the social worker who
    counseled McClain in the period between the ALJ’s decision and Wilson’s
    evaluation indicated that her cognition was within normal limits and her
    intelligence was average. Wilson’s opinion cannot relate back to the period before
    the ALJ’s decision because it appears to be an opinion about a new or worsening
    condition. See HALLEX, I-3-3-6(B)(2).
    McClain contends that our decision in Washington establishes that Wilson’s
    opinion was chronologically relevant. In Washington, the claimant submitted to
    the Appeals Council a psychological evaluation report, prepared after the date of
    the ALJ’s decision, showing that he had cognitive limitations. Washington,
    806 F.3d at 1322. We concluded that the report related back to the period before
    the ALJ’s decision because there was “no assertion or evidence . . . that [the
    claimant’s] cognitive skills declined in the period following the ALJ’s decision.”
    Id. The difference in this case is that there is evidence establishing that McClain
    9
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    had, at least, average intellectual functioning in the period before Wilson’s
    decision. When viewed together with this evidence, Wilson’s opinions show, at
    best, that McClain’s cognitive skills declined in the period following the ALJ’s
    decision. Because Wilson’s opinions about McClain do not relate back to the
    period before the ALJ’s decision, the Appeals Council correctly determined that
    they were not chronologically relevant.
    IV.
    For the reasons set forth above, we affirm the district court’s order affirming
    the Commissioner’s decision to deny benefits.
    AFFIRMED.
    10
    

Document Info

Docket Number: 18-10570

Filed Date: 1/10/2019

Precedential Status: Non-Precedential

Modified Date: 1/10/2019