Keeton v. Department of Health and Human Services, 93-6220
| Decision Date | 31 May 1994 |
| Docket Number | No. 93-6220,93-6220 |
| Citation | 21 F.3d 1064 |
| Parties | , Unempl.Ins.Rep. (CCH) P 17805A Danny KEETON, Plaintiff-Appellant, v. DEPARTMENT OF HEALTH AND HUMAN SERVICES, Defendant-Appellee. |
| Court | U.S. Court of Appeals — Eleventh Circuit |
Philip P. Nelson, Robinson & Nelson, Jasper, AL, George W. Harris, Tuscaloosa, AL, for appellant.
Jack W. Selden, Winfield J. Sinclair, Asst. U.S. Atty., Birmingham, AL, for appellee.
Appeal from the United States District Court for the Northern District of Alabama.
Before HATCHETT and EDMONDSON, Circuit Judges, and SMITH *, Senior Circuit Judge.
FACTS
Danny Keeton appeals from a district court judgment affirming the Secretary of Health and Human Services' denial of his application for disability insurance benefits and supplemental security income under Titles II and XVI of the Social Security Act. At the time of the administrative hearing, Keeton was thirty years old and had an eleventh grade education with no additional vocational training. His past relevant work experience includes jobs as a tire recapper/retreader, bottler, stockboy and sawmill worker. Keeton claims that he is disabled because he suffers pain in his lower back that radiates to his left leg, and the leg gets numb, pain in his spine and in his neck, daily muscle spasms, trembling in both of his hands, and seizures. Keeton uses a TENS unit and a brace as well as various medications to relieve pain.
On August 21, 1990, Keeton filed applications for disability insurance benefits (DIB) and supplemental security income (SSI) after reinjuring his back on the job on September 10, 1989. The Social Security Administration denied Keeton's claims for benefits initially and upon reconsideration. Keeton's subsequent hearing before an administrative law judge (ALJ) also resulted in a denial of benefits on September 25, 1991.
Keeton obtained new counsel, and Keeton's new counsel filed a request for review of the hearing decision and submitted new medical evidence consisting of the sworn testimony of Dr. Charles A. Bush, Keeton's treating physician of approximately three and one-half years. The Appeals Council denied Keeton's request for review on March 25, 1992, thus adopting the ALJ's decision as the final decision of the Secretary. The Appeals Council considered the testimony from Dr. Bush but found it to be cumulative.
On May 7, 1992, Keeton filed an action in the United States District Court for the Northern District of Alabama. The district court affirmed the Secretary's decision and
ruled that the district court would not consider the new evidence from Keeton's treating physician in reaching its determination of whether substantial evidence exists to support the Secretary's decision.
Keeton contends that the district court erred in affirming the Secretary's decision without considering the new evidence from his treating physician; that substantial evidence does not support the decision of the Secretary because the Appeals Council failed to give the proper weight to the testimony of Dr. Bush, Keeton's treating physician; that the ALJ did not properly consider his subjective allegations of pain under the standard mandated in the Eleventh Circuit; and that the ALJ failed to consider the combination of Keeton's two impairments.
The Secretary contends that she properly determined that Keeton was not disabled through substantial evidence and in accordance with law; that the district court properly refused to consider evidence submitted to the Appeals Council because the decision of the ALJ is the final decision of the Secretary under the regulations; that the ALJ properly articulated specific reasons for rejecting Keeton's subjective complaints of incapacitating pain; and that the ALJ properly considered the combined effects of Keeton's impairments.
The issue we address is whether the district court properly refused to consider evidence that was not before the administrative law judge in reaching its determination of whether substantial evidence exists to support the Secretary's decision.
We review the Secretary's decision with deference to the factual findings and close scrutiny of the legal conclusions. Cornelius v. Sullivan, 936 F.2d 1143, 1145 (11th Cir.1991); Martin v. Sullivan, 894 F.2d 1520, 1529 (11th Cir.1990). The Secretary's factual findings are conclusive if "substantial evidence" consisting of "relevant evidence as a reasonable person would accept as adequate to support a conclusion" exists. 42 U.S.C. Sec. 405(g). On the other hand, the Secretary's conclusions of law are not presumed valid. Cornelius, 936 F.2d at 1145; Martin, 894 F.2d at 1529. The Secretary's failure to apply the correct law or to provide the reviewing court with sufficient reasoning for determining that the proper legal analysis has been conducted mandates reversal. Cornelius, 936 F.2d at 1146; Martin, 894 F.2d at 1529.
The "final" decision of the Secretary is subject to judicial review. 42 U.S.C. Sec. 405(g). When the Appeals Council grants review, the Appeals Council decision is reviewable as the final decision of the Secretary. 20 C.F.R. Sec. 404.981. When the Appeals Council refuses to consider new evidence submitted to it and denies review, that decision is also subject to judicial review because it amounts to an error of law. 20 C.F.R. Secs. 404.970(b), 416.1470(b) (). When the Appeals Council denies review, the decision of the ALJ becomes the final decision of the Secretary. 20 C.F.R. Sec. 404.955. In this situation, the question raised is what constitutes the record when the Appeals Council denies review. The Secretary urges this court to adopt the rule that where the decision of the ALJ becomes the final decision of the Secretary, the record only consists of the evidence presented to the ALJ. Keeton urges us to adopt the rule that the record includes additional evidence submitted to the Appeals Council.
The circuits are split on what evidence constitutes the "record" the district court is to review. The Fourth and the Eighth Circuits hold that the administrative record for review includes new evidence submitted to the Appeals Council when the Council accepts or declines to review the case. See Nelson v. Sullivan, 966 F.2d 363, 366 (8th Cir.1992); Browning v. Sullivan, 958 F.2d Since the submission of the evidence precedes the Appeals Council's decision, and that decision, even when it denies review is a precondition to judicial review, the new evidence is a part of the administrative record that goes to the district court in the judicial review proceeding, and then to this court if there is an appeal. It might seem therefore that the district judge and we would be free to consider the new evidence in deciding whether the decision denying benefits was supported by the record as a whole. And of course this is right when the Council has accepted the case for review and made a decision on the merits, based on all the evidence before it, which then becomes the decision reviewed in the courts. It is wrong when the Council has refused to review the case. For then the decision reviewed in the courts is the decision of the administrative law judge. The correctness of that decision depends on the evidence that was before him. [Emphasis added] [citations omitted].
817, 823 n. 4 (8th Cir.1992); Wilkins v. Secretary, 953 F.2d 93, 96 (4th Cir.1991). In Nelson, the Fourth Circuit held that where "the Appeals Council considers the new evidence but declines to review the case, we review the ALJ's decision to determine whether there...To continue reading
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