Reese v. SSA: Post-Dated Mental-Health Reports Are Not Chronologically Relevant Without Pre-Decision Corroboration; De Novo Review Permits Courts to Reach Materiality Not Addressed by the Appeals Council

Introduction

In this unpublished, per curiam decision, the Eleventh Circuit affirmed the denial of Supplemental Security Income (SSI) to Christina Ann Reese. The case presents two recurring issues in Social Security disability adjudication:

When, if ever, must the Appeals Council consider a medical opinion created after an Administrative Law Judge (ALJ) decision?
How precisely must an ALJ explain partial adoption of “moderately persuasive” state-agency medical opinions when formulating the residual functional capacity (RFC)?

Reese argued that (1) the Appeals Council erred in refusing to consider a post-dated psychological evaluation by Dr. June Nichols because it was chronologically relevant to the period before the ALJ’s decision, and (2) the ALJ improperly discounted limitations from two state-agency psychological consultants, Drs. Virginia Bare and Robert Estock, without adequate explanation, particularly with respect to simple-instruction limitations and absenteeism.

The Eleventh Circuit rejected both arguments. Substantively, the panel reiterated that post-decision evidence must be new, material, and chronologically relevant—meaning it must relate to the period on or before the ALJ’s decision—and reaffirmed the Circuit’s de novo review of that issue, including consideration of “materiality” even where the Appeals Council discussed only chronology. Procedurally, the court held that the ALJ sufficiently addressed the “supportability” and “consistency” factors under the new persuasiveness framework and could discount portions of state-agency assessments without addressing every discrete limitation, so long as substantial evidence supports the RFC.

Summary of the Opinion

The court affirmed the district court’s judgment, which had upheld both the Appeals Council’s refusal to consider Dr. Nichols’s August 2022 report and the ALJ’s March 2022 denial of benefits:

Appeals Council/new evidence: Dr. Nichols’s report was not chronologically relevant because it documented mental-health symptoms (e.g., hallucinations, dysthymic mood) that were not reflected in the pre-ALJ record and instead showed progressive deterioration after the ALJ’s decision. Even assuming chronological relevance, the report was likely not material because it conflicted with other record evidence (euthymic mood, lack of hallucinations, normal memory).
ALJ/RFC and medical opinions: The ALJ permissibly found the state-agency opinions “moderately persuasive” but discounted discrete limitations (simple instructions and absenteeism) as inconsistent with later records showing only “mild” limitations and clinical improvement. The ALJ’s combined discussion of the two opinions was allowed, and he was not required to cite every piece of evidence or to specifically parse each limitation where his reasoning and citations showed adequate consideration of the whole record.

Factual and Procedural Background

Reese filed for SSI on October 27, 2020, alleging disability since 2007 due to multiple physical and mental impairments, including hypertension, diabetes, carpal tunnel syndrome, tendonitis, back problems, migraines, depression, anxiety, and COPD. After initial and reconsideration denials, an ALJ held a hearing and issued a March 28, 2022 decision finding Reese not disabled at steps four and five of the familiar five-step sequential evaluation:

Step 1: No substantial gainful activity since application date.
Step 2: Severe impairments included obesity, depression, anxiety, carpal tunnel syndrome, migraines, and COPD.
Step 3: No impairment met or medically equaled a Listing.
RFC: Limited range of light work.
Step 4: Could perform past relevant work as cleaner and home attendant.
Step 5: Alternatively, other representative jobs existed in significant numbers (mail clerk, caller, marker).

After the ALJ’s denial, Reese submitted an August 2022 psychological evaluation by Dr. June Nichols and a source statement to the Appeals Council. The Appeals Council denied review, finding the new report did not relate to the relevant time period. The district court affirmed, and Reese appealed.

Detailed Analysis

I. Appeals Council’s Refusal to Consider Post-Dated Evidence

A. Governing standards

A claimant may submit evidence throughout the administrative process. When evidence is submitted after the ALJ’s decision, the Appeals Council must consider it if it is new, material, and chronologically relevant to the period on or before the ALJ’s decision. See Hargress v. SSA, 883 F.3d 1302, 1308–09 (11th Cir. 2018); 20 C.F.R. § 416.1470(a)(5).

New: Not cumulative of what is already in the record.
Material: A reasonable possibility it would change the administrative result.
Chronologically relevant: Relates to the period on or before the ALJ’s decision, even if created afterward.

Whether these criteria are met is a question of law subject to de novo review. Washington v. SSA, 806 F.3d 1317, 1321 (11th Cir. 2015). Importantly, under Eleventh Circuit precedent, appellate courts may assess criteria the Appeals Council did not expressly reach—such as materiality—even if the Council addressed only chronology. See Washington, 806 F.3d at 1321; Hargress, 883 F.3d at 1310. The panel acknowledged potential tension with SEC v. Chenery Corp., 332 U.S. 194 (1947), but reaffirmed that the Eleventh Circuit’s prior-panel-precedent rule binds the court to Washington and Hargress. See United States v. Archer, 531 F.3d 1347, 1352 (11th Cir. 2008); United States v. Fritts, 841 F.3d 937, 942 (11th Cir. 2016).

B. Application to Dr. Nichols’s report

Dr. Nichols’s August 2022 evaluation summarized records from 2009–2022, documented current observations (e.g., dysthymic mood, anxious affect, reported auditory/visual hallucinations), and diagnosed several mental disorders, with a source statement estimating 30% off-task behavior and more than 10 absences in 30 days. The form indicated these impairments existed as of the October 27, 2020 application date.

The panel held the report was not chronologically relevant:

The critical symptoms Dr. Nichols observed (e.g., hallucinations; severe depressive symptomatology) were not documented in the pre-ALJ record.
The report indicated post-ALJ deterioration, making it “about a later time” rather than about the adjudicated period. See Hargress, 883 F.3d at 1309.
Merely checking a form to backdate impairments to the application date, without corroborating pre-ALJ evidence of those symptoms, did not establish chronological relevance.

The court added that, even assuming chronological relevance, the report was likely not material because it was unsupported by and, at points, contradicted by the record before the ALJ (euthymic mood, lack of hallucinations, no suicidal ideation, normal memory). See Washington, 806 F.3d at 1322 (assessing whether new evidence is wholly inconsistent with the ALJ record when evaluating materiality).

C. Key takeaways on Appeals Council practice

Post-dated opinions can be chronologically relevant, but only if they meaningfully relate back—e.g., by tying current findings to documented pre-ALJ symptoms or findings.
Check-the-box backdating, unmoored from the pre-ALJ record, is insufficient.
Even if chronologically relevant, new evidence must be material; contradictions with pre-ALJ evidence undercut materiality.
On judicial review in the Eleventh Circuit, courts may evaluate both chronology and materiality de novo, even if the Appeals Council only addressed one criterion.

II. ALJ’s Treatment of State-Agency Opinions and RFC

A. Standards of review and articulation under the 2017 regulations

Judicial review:
- Legal principles are reviewed de novo. Raper v. Comm’r of Soc. Sec., 89 F.4th 1261, 1268 (11th Cir. 2024).
- Factual findings are reviewed for substantial evidence—relevant evidence a reasonable person would accept to support a conclusion; courts do not reweigh evidence. Winschel v. Comm’r of Soc. Sec., 631 F.3d 1176, 1178 (11th Cir. 2011); Buckwalter v. Acting Comm’r of Soc. Sec., 5 F.4th 1315, 1320 (11th Cir. 2021).
ALJ’s duty and RFC: The ALJ must develop a full and fair record and account for all relevant medical and other evidence in formulating the RFC. Henry v. Comm’r of Soc. Sec., 802 F.3d 1264, 1267 (11th Cir. 2015); 20 C.F.R. § 416.945(a)(1).
Medical opinions (post-2017 rules): The ALJ evaluates “persuasiveness,” with “supportability” and “consistency” as the most important factors. The decision must explain those two factors. 20 C.F.R. § 416.920c(b)(2).

B. The consultants’ opinions and the ALJ’s reasoning

Reese argued the ALJ improperly omitted two limitations when he found the state-agency opinions “moderately persuasive”: (1) limitations in understanding and remembering simple instructions, and (2) an absenteeism prediction (one to two days per month). The Eleventh Circuit disagreed, finding the ALJ’s analysis sufficient:

Supportability: The ALJ found both opinions adequately supported by cited evidence.
Consistency and updates: The ALJ weighed those opinions against later evidence showing mild depressive symptoms and improvement at a 2022 follow-up, including findings of only mild limitations in understanding/remembering/applying information. That later evidence conflicted with the consultants’ earlier “moderate” limitations and supported omitting the disputed simple-instruction restriction.
Absenteeism: The ALJ did not err by not expressly parsing Dr. Estock’s absenteeism estimate. He found the opinion moderately persuasive, generally supported and consistent, and stated that he considered the record and opinions in their entirety. The law does not require the ALJ to cite every piece of evidence or discuss every sub-limitation where his path of reasoning is reasonably discernible and supported. See Buckwalter, 5 F.4th at 1326.
Format of discussion: The ALJ permissibly discussed the two opinions together; § 416.920c(b)(1) addresses multiple opinions from the same source and does not prohibit a combined analysis across sources.

In sum, substantial evidence supported the ALJ’s RFC determination and his decision to discount discrete limitations that were inconsistent with the overall (and updated) record. See Hargress, 883 F.3d at 1306 (inconsistency with other medical records is a proper reason to discount an opinion).

III. Precedents Cited and Their Influence

Washington v. SSA, 806 F.3d 1317 (11th Cir. 2015): Established that new evidence presented to the Appeals Council must be considered if new, material, and chronologically relevant; appellate review of those criteria is de novo, and courts may evaluate criteria not expressly reached by the Council. This case undergirds the panel’s willingness to discuss materiality, even though the Appeals Council addressed only chronology.
Hargress v. SSA, 883 F.3d 1302 (11th Cir. 2018): Reaffirmed Washington and clarified that post-dated records showing deterioration after the ALJ’s decision are “about a later time,” thus not chronologically relevant. The panel applied that principle to Dr. Nichols’s report to find it non-chronologically relevant.
SEC v. Chenery Corp., 332 U.S. 194 (1947): Generally limits judicial review to the agency’s stated reasons. The panel acknowledged possible tension but applied the Eleventh Circuit’s prior-panel-precedent rule to follow Washington and Hargress.
United States v. Archer, 531 F.3d 1347 (11th Cir. 2008), and United States v. Fritts, 841 F.3d 937 (11th Cir. 2016): Articulate the prior-panel-precedent rule that binds later panels. These cases justify adhering to Washington/Hargress notwithstanding Chenery concerns.
Doughty v. Apfel, 245 F.3d 1274 (11th Cir. 2001): Clarifies that when the Appeals Council denies review, the ALJ’s decision is the Commissioner’s final decision for judicial review purposes.
Raper v. Comm’r of Soc. Sec., 89 F.4th 1261 (11th Cir. 2024): Confirms de novo review of legal questions in Social Security appeals.
Winschel v. Comm’r of Soc. Sec., 631 F.3d 1176 (11th Cir. 2011), and Buckwalter v. Acting Comm’r of Soc. Sec., 5 F.4th 1315 (11th Cir. 2021): Articulate substantial-evidence review and emphasize that courts do not reweigh evidence; Buckwalter also notes ALJs need not cite every piece of evidence so long as the decision shows consideration of the record as a whole.
Henry v. Comm’r of Soc. Sec., 802 F.3d 1264 (11th Cir. 2015): Describes the ALJ’s duty to develop a full and fair record.

IV. Legal Reasoning: How the Court Reached Its Decision

On new evidence: The court compared Dr. Nichols’s post-dated observations to the pre-ALJ record. Because the key symptoms (e.g., hallucinations) were not documented before the ALJ decision, the court inferred the report reflected post-decision decline rather than providing a retrospective assessment of the adjudicated period. The check-mark indicating onset back to the application date lacked adequate record support. The court also performed a materiality cross-check, concluding the report was unlikely to change the outcome due to contradictions with the ALJ-era record.
On RFC and opinion evidence: The court accepted the ALJ’s articulation of supportability and consistency, noting the ALJ’s reliance on later evidence showing improvement and “mild” limitations that contradicted “moderate” limitations opined by the consultants. The ALJ’s combined discussion and failure to specifically analyze an absenteeism estimate were not legal error given the overall explanation and substantial-evidence support.

V. Impact and Practical Implications

A. For claimants and advocates

Timing and content of new evidence: Post-decision examinations must explicitly tie their findings to the pre-ALJ record. Retrospective opinions should identify specific pre-decision symptoms, test results, and treatment notes that corroborate the asserted limitations. A conclusory backdated onset statement is vulnerable.
When deterioration occurs after the ALJ decision: Consider whether a new application or a request for remand under sentence six of 42 U.S.C. § 405(g) (if criteria are met) is the appropriate vehicle, rather than relying on Appeals Council review premised on chronology.
Opinion evidence under the 2017 rules: To preserve limitations, develop “supportability” (citations to objective signs, labs, testing, longitudinal notes) and “consistency” (alignment with other record sources). Where later records show improvement or milder restrictions, address that explicitly.
Absenteeism estimates: Because ALJs are not required to analyze every sub-opinion in isolation, build a record that compels discussion: tie absenteeism to specific, longitudinally documented exacerbations, hospitalizations, or provider-imposed restrictions, and reconcile with any “mild” findings.

B. For ALJs and the agency

Articulation sufficiency: This decision endorses concise but targeted explanations centered on supportability and consistency, and recognizes the propriety of discounting discrete limitations where later evidence shows milder impairments.
Combined discussion format: The court confirms that grouping multiple sources in a single discussion is permissible, provided the reasoning remains clear.

C. Doctrinal significance within the Eleventh Circuit

Reaffirmation of de novo scope: The panel reaffirms Washington/Hargress: appellate courts in this Circuit may evaluate both chronological relevance and materiality even if the Appeals Council considered only one. The court expressly acknowledges Chenery but treats Washington/Hargress as binding via the prior-panel-precedent rule.
Chronological relevance threshold: The decision illustrates that evidence showing new or worsened symptoms after the ALJ is not chronologically relevant, even if the evaluator reviews historical records and backdates onset on a form. Corroboration in the pre-ALJ record is essential.

Complex Concepts Simplified

Appeals Council: The body within SSA that reviews ALJ decisions upon request. It can deny review or remand. For post-decision evidence, it applies a “new, material, and chronologically relevant” test.
Chronologically relevant: The evidence must meaningfully relate to the period up to the ALJ decision. A later exam can qualify if it reliably assesses the claimant’s earlier condition, with support from pre-ALJ records.
Material: There must be a reasonable possibility the evidence would change the result. If the new evidence contradicts or is unsupported by the ALJ-era record, materiality is doubtful.
Residual Functional Capacity (RFC): The most a claimant can do in a work setting despite limitations. The ALJ must consider all relevant evidence to craft the RFC.
Supportability and Consistency (2017 rules): Supportability asks: how well does a medical source explain and support the opinion with objective evidence? Consistency asks: how well does the opinion fit with the rest of the record? These are the two most important persuasiveness factors.
Substantial evidence: A deferential standard: if a reasonable person could accept the evidence as adequate to support the ALJ’s findings, courts must affirm—even if other evidence could support a different outcome.
Prior-panel-precedent rule: Within the Eleventh Circuit, earlier published panel decisions bind later panels unless overruled by the court en banc or by the Supreme Court.
Unpublished decision: Marked “Not for publication,” this opinion is not binding precedent in the Eleventh Circuit, but it is persuasive authority and signals how the court is likely to apply settled principles.

Conclusion

Reese v. SSA underscores two practical and doctrinal points in Eleventh Circuit Social Security litigation. First, post-dated medical opinions offered to the Appeals Council must do more than recite a backdated onset—they must be anchored in the pre-ALJ record to be chronologically relevant and must plausibly change the outcome to be material. The court reaffirmed its de novo authority to review both chronology and materiality, notwithstanding Chenery, by invoking prior-panel precedent. Second, under the revised persuasiveness framework, ALJs may accept medical opinions as generally persuasive yet reasonably discount discrete limitations based on later or more comprehensive evidence, without parsing every sub-finding, provided their reasoning on supportability and consistency is clear and supported by substantial evidence.

For claimants and counsel, the decision emphasizes careful development of pre-hearing records, proactive acquisition of corroborating evidence, and tailored articulation of how new opinions relate back to the adjudicated period. For adjudicators, it validates succinct but focused RFC analyses that engage the record’s evolution over time. The judgment—affirmed at every level—reflects the court’s adherence to established standards governing Appeals Council evidence, RFC formulation, and judicial review.