Tony Griffin appeals the district courts order affirming the Social Security Commissioners (“Commissioner”) denial of his applications for supplemental security income (“SSI”). Griffin argues on appeal that the Appeals Council erred when it denied review without mentioning Dr. June Nicholss psychological evaluation and holding that the post-decision records were not chronologically relevant, and that the denial was not supported by substantial evidence when the evidence submitted to the Appeals Council was considered.
In a social security case, we review the agencys legal conclusions de novo, and its factual findings to determine whether they are supported by substantial evidence. Ingram v. Comm’r of Soc. Sec. Admin., 496 F.3d 1253, 1260 (11th Cir. 2007). “Substantial evidence is more than a scintilla and is such relevant evidence as a reasonable person would accept as adequate to support a conclusion.” Winschel v. Commr of Soc. Sec. Admin., 631 F.3d 1176, 1178 (11th Cir. 2011). “We may not decide the facts anew, reweigh the evidence, or substitute our judgment for that of the Commissioner.” Id. (quotation marks and brackets omitted). We have applied the harmless error doctrine to Social Security appeals. See Diorio v. Heckler, 721 F.2d 726, 728 (11th Cir. 1983). Whether evidence meets the new, material, and chronologically relevant standard is a question of law subject to de novo review. Washington v. Soc. Sec. Admin., Commr, 806 F.3d 1317, 1320-21 (11th Cir. 2015). The Appeals Council commits reversible error when it improperly refuses to consider evidence. Id.
A disability is defined as an “inability to engage in any substantial gainful activity by reason of any medically determinable physical or mental impairment which can be expected to result in death or which has lasted or can be expected to last for a continuous period of not less than 12 months.” 42 U.S.C. § 423(d)(1)(A).
An individual claiming Social Security disability benefits must prove that she is disabled. Moore v. Barnhart, 405 F.3d 1208, 1211 (11th Cir. 2005). The Social Security regulations establish a five-step, “sequential” process for determining whether a claimant is disabled. 20 C.F.R. § 416.920(a)(1). Throughout the process, the burden is on the claimant to introduce evidence in support of her application for benefits. Ellison v. Barnhart, 355 F.3d 1272, 1276 (11th Cir. 2003). If an administrative law judge (“ALJ”) finds a claimant disabled or not disabled at any given step, the ALJ does not go on to the next step. 20 C.F.R. § 416.920(a)(4). At the first step, the ALJ must determine whether the claimant is currently engaged in substantial gainful activity. Id. § 416.920(a)(4)(i), (b). At the second step, the ALJ must determine whether the impairment or combination of impairments for which the claimant allegedly suffers is “severe.” Id. § 416.920(a)(4)(ii), (c). At the third step, the ALJ must decide whether the claimants severe impairments meet or medically equal a listed impairment. Id. § 416.920(a)(4)(iii), (d). Where, as here, the ALJ finds that the claimants severe impairments do not meet or equal a listed impairment, the ALJ must then determine, at step four, whether she has the residual functional capacity (“RFC”) to perform her past relevant work. Id. § 416.920(a)(4)(iv), (e)-(f). “[RFC] is an assessment ․ of a claimants remaining ability to do work despite his impairments.” Lewis v. Callahan, 125 F.3d 1436, 1440 (11th Cir. 1997). If the claimant cannot perform her past relevant work, the ALJ must then determine, at step five, whether the claimants RFC permits her to perform other work that exists in the national economy. 20 C.F.R. § 416.920(a)(4)(v), (g). Finally, the burden shifts back to the claimant to prove she is unable to perform the jobs suggested by the Commissioner. Hale v. Bowen, 831 F.2d 1007, 1011 (11th Cir. 1987).
Generally, a claimant may present evidence at each stage of the social security administrations administrative review process. See Hargress v. Soc. Sec. Admin., Commr, 883 F.3d 1302, 1308–09 (11th Cir. 2018). If a claimant presents evidence after the ALJs decision, the Appeals Council must consider whether the evidence is: new; chronologically relevant, i.e., it relates to the period on or before the ALJs hearing decision; and material, i.e., there is a reasonable probability that it would change the administrative result. See id. at 1309. The Appeals Council must grant the petition for review if the ALJs decision is contrary to the weight of the evidence, including the new evidence. Id. The Appeals Council is not required to provide a detailed rationale for denying review. Mitchell v. Soc. Sec. Admin., Commr, 771 F.3d 780, 784 (11th Cir. 2014).
Medical opinions based on treatment occurring after the date of the ALJs decision may be chronologically relevant. Washington, 806 F.3d at 1322. In Washington, the claimant submitted to the Appeals Council a psychologists evaluation and accompanying opinion about the degree of the claimants mental limitations, which were prepared seven months after the ALJs decision. Id. at 1319-20. We concluded that the psychologists materials were chronologically relevant because: (1) the claimant described his mental symptoms during the relevant period to the psychologist, (2) the psychologist had reviewed the claimants mental health treatment records from that period, and (3) there was no evidence of the claimants mental decline since the ALJs decision. Id. at 1319, 1322-23 (limiting our holding to “the specific circumstances of this case”). We found that the medical opinion submitted to the Appeals Council was material because, if accepted, the opinion could establish that the claimant had an impairment that met or equaled a specific listed disability. Id. at 1321.
But we have held that the Appeals Council correctly declined to consider new medical records because the records were “about a later time” than the ALJs decision, and, therefore, did not affect the decision about whether the claimant was disabled during the relevant period. Hargress, 883 F.3d at 1309. In Hargress, the Appeals Council denied the appellants petition for review and refused to consider her newly-submitted evidence—which included medical records dated after the ALJs decision—stating that the new records were “about a later time” than the ALJs decision, and therefore did not affect the ALJs decision as to whether she was disabled prior to the date of that decision. Id. We stated that “the Appeals Council declined to consider these new medical records because they were not chronologically relevant. The Appeals Council was not required to give a more detailed explanation or to address each piece of new evidence individually.” Id. We also held that the new records were not relevant because nothing in them indicated that the doctors had reviewed the appellants medical records, or that the information in them related to the period at issue. Id. at 1309–10. We held that newly submitted medical records from a doctor who had previously submitted medical records were not material because the new records contradicted the doctors other records and were inconsistent with medical records created during the relevant time period. Id. Because we found that the Appeals Council was not required to consider the immaterial evidence, we declined to address the claimants argument that the denial of benefits was erroneous when the new evidence was considered. Id. at 1310.
The ALJ may reject the opinion of any physician if the evidence supports a contrary conclusion. Sryock v. Heckler, 764 F.2d 834, 835 (11th Cir. 1985). The more a medical source presents relevant evidence to support an opinion, particularly medical signs and laboratory findings, the more weight the ALJ will give that opinion. 20 C.F.R. § 416.927(c)(3). The Commissioner, not a claimants physician, is responsible for determining whether the claimant is statutorily disabled. 20 C.F.R. § 404.1527(d)(1). Specifically, “[a] statement by a medical source that [a claimant is] ‘disabled’ or ‘unable to work’ does not mean that [the Commissioner] will determine that [the claimant is] disabled.” Id. Although a claimant may provide a statement containing a physicians opinion of her remaining capabilities, the ALJ will evaluate such a statement in light of the other evidence presented and the ultimate determination of disability is reserved for the ALJ. 20 C.F.R §§ 404.1513, 404.1527, 404.1545.
Here, the Appeals Council did not err by declining to consider the new evidence Griffin submitted because some of the evidence was dated after the ALJs decision and thus not chronologically relevant, and the remaining evidence, including Dr. Nicholss evaluation, was immaterial because it was in conflict with the other record evidence and thus unlikely to change the administrative result. First, Dr. Feists mental health statement did not cite to any medical evidence to support his conclusions that the limitations existed beginning in July 2012. He merely indicated the limitations via the questionnaire and did not provide any reference to Griffins medical records from the relevant time period to support his conclusion that the limitations did apply during the relevant time period. It is likely that the ALJ would not give weight to the conclusions in this mental health statement because it did not reference any supporting evidence from the medical record. 20 C.F.R. § 416.927(c)(3). Similarly, Dr. Feists letter regarding the emotional support animal did not cite to any medical records to support his prescription, so the ALJ would likely not give weight to any conclusion from the letter. Further, Dr. Feists letter indicated only that Griffin had a mental disability that caused functional limitations and anxiety, a conclusion that the ALJ already reached.
Second, Dr. Feists and Dr. Nicholss conclusions about Griffins limitations during the relevant time period, from January 2016 to July 2018, were not supported by the other record evidence. Dr. Feist concluded that the various limitations, including that Griffin would not be able to maintain attention, concentration, and/or pace for periods of at least two hours, perform activities within a schedule and be punctual within customary tolerances, or adjust to routine frequent work changes, existed beginning in July 2012. Dr. Nichols concluded that Griffin was unable to maintain attention and pace for periods of at least two hours or a regular schedule with punctuality, was unable to maintain a regular job without missing more than one to two days per month, and was unable to sustain an ordinary work routine without the need for special supervision. She found that he was unable to seek and accept instructions from supervisors or to maintain appropriate appearance, behavior, or social interaction in a workplace. These findings are not supported by, and often in conflict with, the bulk of the record evidence. For example, records from Dr. Feists examinations of Griffin between February 2015 and November 2017 consistently showed that, although Griffin was presenting with anxiety and depression, he had adequate concentration, appropriate behavior, and fair insight and judgment, and he was either moderate or low risk. Even when Griffin reported suffering from hallucinations, Dr. Feist concluded in September 2017 that his insight and judgment were good, his thought processes were logical, his concentration and attention were adequate, his energy and motivation were good, and his behavior was appropriate. After Griffins overdose, when he saw Dr. Feist in November 2017, Griffin reported that recently his medication was working very well, he was sleeping great, and his hallucinations were improving. Dr. Feist found that Griffins insight and judgment were good, his thought content was logical, and his concentration and attention were adequate. These evaluations conflict with the findings that Griffin would not be able to pay attention or perform work tasks within a schedule or that he would not be able to maintain appropriate workplace appearances or behavior.
Further, the records from between January 2014 and September 2017 from Griffins visits to Dr. Johnson consistently showed that, although Griffin had generalized anxiety disorder and suffered from some depression, Griffins anxiety was improving greatly with medication, he had a calm mood and stable nerves, he was better able to rest and cope with daily stresses, and he did not have homicidal or suicidal ideation. Dr. Johnson consistently maintained that Griffin was oriented and had a normal mental status during this time. Further, during Griffins visits between May 2016 and September 2017, he consistently reported that his anxiety was manageable with medication, noting that his anxiety worsened slightly after stopping Valium. He denied hallucinations, delusions, abnormal thinking, nervousness, or depression. Dr. Johnson did not observe any anxiety, delusion, loose associations, flight of thought, stressed facies, or weeping during these visits. Records from February, March, and April 2013 showed that Griffin denied any anxiety or depression during that time. All of these records conflicted with the conclusions that Drs. Feist and Nichols made because they showed that Griffin consistently maintained a normal mental status, benefitted from continuing his medication, was able to complete his daily tasks, and frequently did not report or exhibit any anxiety or depression during those visits. Hargress, 883 F.3d at 1309-10.
Further, the evidence that Dr. Nichols cited to in her evaluation was the same record evidence already considered by the ALJ and used to determine that Griffin did suffer from severe depression and PTSD. The ALJ also already attributed several limitations to Griffin based on the evidence examined by Dr. Nichols, including the required breaks in the workday included in the RFC as well as limiting his interaction with and exposure to other people and changes in the workplace. Thus, the ALJ already acknowledged that Griffin had severe mental impairments and concluded that the limitations listed in the RFC were sufficient to account for the severity of his impairments as shown by the record evidence. Finally, given the ALJs reasoning for denying Griffins application—specifically its reasoning that Griffins symptoms appear to improve when he is on medication—Dr. Nicholss conclusion that his most severe symptoms were a result of his inability to stay on his prescribed medications would not change the ALJs decision and is in fact consistent with it.
Accordingly, the new evidence was either not chronologically relevant or immaterial. Thus, the Appeals Council was not required to consider it, and it is therefore not necessary to address Griffins argument that the denial of benefits was not supported by substantial evidence when this new evidence is considered. Hargress, 883 F.3d at 1310. Accordingly, we affirm.
AFFIRMED.
PER CURIAM: