Court Opinion

ID: 9956445
Source: CourtListenerOpinion
Date Created: 2024-04-02 14:00:36.730296+00
Date Added: 2024-06-11T08:17:32.687866
License: Public Domain

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                                                    [DO NOT PUBLISH]
                                    In the
                 United States Court of Appeals
                         For the Eleventh Circuit

                           ____________________

                                 No. 22-10999
                           ____________________

        MELISSA ANN SPURGEON,
                                                       Plaintiﬀ-Appellant,
        versus
        SOCIAL SECURITY ADMINISTRATION, COMMISSIONER,

                                                     Defendant-Appellee.

                           ____________________

                  Appeal from the United States District Court
                     for the Northern District of Alabama
                     D.C. Docket No. 4:20-cv-00782-NAD
                           ____________________

        Before ROSENBAUM, NEWSOM, and TJOFLAT, Circuit Judges.
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        2                      Opinion of the Court                 22-10999

        PER CURIAM:
               Melissa Ann Spurgeon appeals the district court’s order af-
        firming the decision of the Commissioner of the Social Security Ad-
        ministration (“Commissioner”) denying her application for disabil-
        ity-insurance benefits. First, she argues that the administrative law
        judge (“ALJ”) failed to give the opinions of her treating physician
        special weight under the “treating-physician rule.” Though
        Spurgeon admits that 20 C.F.R. § 404.1520c (2017) did away with
        the treating-physician rule, she asserts that the regulation did so
        only in derogation of the Social Security Act, which itself imposes
        the treating-physician rule in 42 U.S.C. § 423(d)(5)(B). Second, she
        contends that the Appeals Council erred when it failed to consider
        the opinion of Dr. June Nichols, which Spurgeon submitted to the
        Appeals Council as new evidence, without explaining why it de-
        clined to do so.
               After careful consideration, we affirm the district court’s de-
        cision. We have already held that 20 C.F.R. § 404.1520c (2017) ab-
        rogated the treating-physician rule, and 42 U.S.C. § 423(d)(5)(B)
        does not independently require such a rule. Harner v. Social Security
        Administration, Commissioner, 38 F.4th 892, 894, 897–98 (11th Cir.
        2022). So under our precedent, the district court did not err in de-
        clining to give special weight to the opinions of Spurgeon’s treating
        physician.
               And even though the Appeals Council did not mention the
        opinion of Dr. Nichols when it denied review, we cannot remand
        the case to the Commissioner because the opinion was immaterial.
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        22-10999                  Opinion of the Court                              3

               So we affirm.
                                  I.      BACKGROUND1

                Spurgeon applied for disability-insurance benefits on Febru-
        ary 21, 2018, at age 44. She previously worked as a medical assis-
        tant. When she applied for benefits, Spurgeon alleged disability
        with an onset date of February 12, 2016, based on orthostatic hy-
        potension, dysautonomia, palpitations, hypertension, paroxysmal
        supraventricular tachycardia, anxiety, mitral valve prolapse, obe-
        sity, blood pooling in lower extremities, and brain fog.
               Medical records from the relevant timeframe show that
        Spurgeon was diagnosed with several health conditions, including
        dysautonomia, hypertension, tachycardia, anxiety, obesity, neu-
        ropathy, and leg pain, among others. They also show that many
        doctors, across various visits, found Spurgeon to be alert, coopera-
        tive, and oriented, with intact cognitive function, normal mood,
        and normal affect. Medical records from various doctors also
        found Spurgeon to have no physically remarkable symptoms. And
        some of Spurgeon’s symptoms, including her anxiety, improved
        with treatment and medications.
               Spurgeon filed several medical opinions in the administra-
        tive record. The ALJ found two of these opinions to be persuasive

        1 The Court reviewed the entire record, including information in the medical

        records and opinions that may not be mentioned in this section. Here, we
        highlight the records, conditions, and opinions essential to understanding our
        ruling and reasoning.
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        4                     Opinion of the Court                22-10999

        and consistent with the medical records. First, Dr. Robert Estock
        concluded Spurgeon could concentrate and attend to simple tasks
        for two hours. Dr. Estock also said Spurgeon could tolerate ordi-
        nary work pressures, but she should avoid excessive workloads,
        quick decision making, rapid changes, and multiple demands. Sec-
        ond, Dr. Jerry Bynum opined that Spurgeon’s ability to understand
        instructions was not impaired, but her ability to carry them out was
        mildly impaired because of mental-health symptoms. He found
        that she had a moderate impairment in her ability to respond ap-
        propriately to supervision, coworkers, and work pressures, a mild
        impairment in communications, and a moderate social impair-
        ment. He also concluded she had no cognitive impairment and
        could manage her own benefits.
               On the other hand, the ALJ found the opinions of Dr. Barton
        Perry, one of Spurgeon’s treating physicians, to be unpersuasive
        because they were inconsistent with other medical records. As to
        her psychological condition, in relevant part, Dr. Perry opined that
        Spurgeon could understand and carry out short and simple instruc-
        tions, but she could not maintain concentration for two hours, ad-
        here to a schedule, adjust to routine work changes, interact with
        supervisors or coworkers, or maintain socially appropriate behav-
        ior. He expected that she would be off task for eighty percent of
        the workday and miss fifteen days of work in a thirty-day period
        because of psychological symptoms. In a separate opinion he is-
        sued on the same day, concerning Spurgeon’s physical condition,
        Dr. Perry opined that Spurgeon could sit or stand for only one hour
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        22-10999              Opinion of the Court                        5

        at a time, would be off task for most of the day, and was expected
        to miss ten days of work in a thirty-day period.
               The ALJ found Dr. Perry’s opinions to be unpersuasive be-
        cause they “provide no nexus between the conditions he cites and
        the limitations.” The ALJ also pointed to medical records spanning
        the relevant years that were inconsistent with Dr. Perry’s opinions.
        For example, the ALJ cited medical records that did not indicate the
        physical restrictions in Dr. Perry’s opinions. He also highlighted
        records showing that Spurgeon’s generalized anxiety disorder and
        certain physical symptoms were controlled through medication.
        And he relied on medical records that, as noted above, showed
        Spurgeon to be alert, oriented, and negative for confusion, behav-
        ior problems, and mood swings.
               At the hearing before the ALJ, Spurgeon testified that she
        had several serious health issues, had trouble standing for more
        than ten minutes, could not focus on a two-hour movie, and
        needed to elevate her legs for four hours a day. A vocational expert
        then testified that, though Spurgeon would be unable to perform
        any of her past work, a person with the limitations she was found
        to have could perform other jobs that existed in significant num-
        bers in the national economy. The expert also testified that if
        Spurgeon were off task more than five percent of the workday or
        missed more than one day of work a month, she would be unable
        to maintain a job.
              After the hearing, the administrative law judge denied
        Spurgeon’s application. In the opinion, the ALJ went through the
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        6                      Opinion of the Court                  22-10999

        five-step process required to determine if a claimant qualifies for
        disability benefits under 20 C.F.R. § 404.1520(a)(4)(i)–(v). The ALJ
        ultimately denied disability-insurance benefits because, even
        though Spurgeon could not perform any of her past relevant work,
        he concluded that jobs in the national economy that Spurgeon
        could perform existed in significant numbers.
               Spurgeon sought review from the Appeals Council. She re-
        quested sixty days to submit additional evidence. The Appeals
        Council agreed not to act for twenty-five days, allowing her to sub-
        mit new evidence until February 5, 2020. A day before the dead-
        line, on February 4, Spurgeon submitted one additional medical
        opinion.
               However, Spurgeon did not submit a new medical opinion
        from Dr. June Nichols (“the Nichols Opinion”) until May 22, more
        than three months past the deadline and only four days before the
        Appeals Council issued its decision. Dr. Nichols opined that
        Spurgeon likely had difficulty concentrating for two hours, inter-
        acting with supervisors and coworkers, and maintaining socially
        appropriate behaviors. The opinion concluded that Spurgeon
        would have difficulty following a schedule, was likely unable to ad-
        just well to work changes, would likely be off task forty-to-fifty per-
        cent of the time, and would likely miss fifteen workdays in a thirty-
        day period. Dr. Nichols stated these limitations “would have ex-
        isted prior to 2/12/16.”
              Four days after Spurgeon submitted the Nichols Opinion,
        the Appeals Council denied the request to review the ALJ decision.
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        22-10999               Opinion of the Court                          7

        As to the new opinion that Spurgeon submitted before the Appeals
        Council’s deadline for new evidence, the Appeals Council found it
        was not chronologically relevant and declined to consider it. As to
        the Nichols Opinion, which Spurgeon submitted after the Appeals
        Council’s deadline, the Appeals Council did not mention it at all in
        the denial. The decision included a notice of Spurgeon’s right to
        appeal the denial in federal court.
                Spurgeon filed for review of the denial of benefits in the dis-
        trict court. She also filed a “Motion To Remand Pursuant To Sen-
        tences 4 & 6” of 42 U.S.C. § 405(g). The district court affirmed the
        denial of disability-insurance benefits and denied the motion to re-
        mand. Spurgeon timely filed this appeal.

                                 II.     DISCUSSION

                We review de novo an ALJ’s application of law. Buckwalter
        v. Acting Comm’r of Soc. Sec., 5 F.4th 1315, 1320 (11th Cir. 2021). We
        also review de novo the Appeals Council’s refusal to consider new
        evidence. Pupo v. Comm’r, Soc. Sec. Admin., 17 F.4th 1054, 1063
        (11th Cir. 2021).
               First, we address whether Spurgeon forfeited her arguments
        supporting her position that the treating-physician rule required
        the ALJ to give Dr. Perry’s opinions special weight. We conclude
        she did not. So we then consider the merits of these arguments and
        find that the ALJ did not owe Dr. Perry’s opinions special weight.
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        8                      Opinion of the Court                    22-10999

        Finally, we assess whether the Appeals Council erred in declining
        to consider the Nichols Opinion. We conclude it did not.
                  A. Spurgeon did not forfeit her treating-physician-rule ar-
                                            guments.

              On appeal, the arguments Spurgeon raises about the treat-
        ing-physician rule differ from those she relied on in the district
        court. So before discussing the merits, we must decide whether
        Spurgeon forfeited these arguments. We hold that she did not.
                Generally, we don’t review issues raised for the first time on
        appeal. In re Home Depot Inc., 931 F.3d 1065, 1086 (11th Cir. 2019).
        But we’ve observed that “there is a difference between raising new
        issues and making new arguments on appeal.” Id. And if an issue
        is “properly presented, a party can make any argument in support
        of that [issue]; parties are not limited to the precise arguments they
        made below.” Id. (quoting Yee v. City of Escondido, 503 U.S. 519, 534
        (1992)). In Home Depot, for instance, Home Depot changed its ar-
        gument on appeal, relying on a different line of precedents than it
        did in the district court. Id. In fact, the party’s argument on appeal
        actually was inconsistent with its argument in the district court. Id.
        Even so, we held that Home Depot had not waived its new argu-
        ment because it was making the same bottom-line request—that
        is, it was raising the same issue—both at the district court and on
        appeal; it was just using different reasons to argue its position on
        the issue. Id.
               On the other hand, in Social Security cases, we’ve said that,
        “[a]s a general principle, this court will not address an argument
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        22-10999               Opinion of the Court                          9

        that has not been raised in the district court.” Stewart v. Dep’t of
        Health & Human Servs., 26 F.3d 115, 115 (11th Cir. 1994) (emphasis
        added). But in Stewart, the claimant filed no briefs in the district
        court, so he did not raise any issues in the district court. See id. at
        115–16. Thus, he could not raise any arguments on appeal because
        they all related to forfeited issues. And in Kelley v. Apfel, 185 F.3d
        1211, 1215 (11th Cir. 1999), although we said that the claimant for-
        feited the “argument” that the ALJ should not have relied on the
        testimony of a vocational expert, whether the ALJ should have re-
        lied on a vocational expert was a new issue, not a new argument.
               In short, it’s clear from our opinions that even though we’ve
        sometimes inartfully employed the term “argument” instead of “is-
        sue” when we’ve discussed forfeiture, we’ve always applied the for-
        feiture rule to issues, not arguments.
               And here, Spurgeon raises new arguments, not a new issue.
        Both at the district court and on appeal, Spurgeon asserted that the
        ALJ did not give the opinions of Dr. Perry, her treating physician,
        enough weight under the treating-physician rule. In the district
        court, she argued that our treating-physician-rule precedents sur-
        vived the new Social Security regulation, so the ALJ still had to give
        Dr. Perry’s opinion special weight. But after the district court re-
        jected that argument and issued its opinion, we held that 20 C.F.R.
        § 404.1520c (2017) abrogated our earlier precedents applying the
        treating-physician rule. Harner v. Soc. Sec. Admin., Comm’r, 38 F.4th
        892 (2022). So on appeal, Spurgeon understandably changed her
        arguments. Now, she contends that even if we cannot rely on prior
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        10                      Opinion of the Court                  22-10999

        precedent, the Social Security Act itself requires the existence of the
        treating-physician rule.
               At both stages of the litigation, Spurgeon’s arguments go to
        the issue of whether the ALJ erred by not giving her treating physi-
        cian’s opinion enough weight. So we will consider Spurgeon’s
        treating-physician-rule arguments.
                     B. The ALJ did not err by refusing to give Spurgeon’s
                          treating physician’s opinions special weight.

                Spurgeon argues that the ALJ erred by failing to give Dr.
        Perry’s opinions “substantial weight” under the treating-physician
        rule. The treating-physician rule in this Circuit used to require
        ALJs to give substantial or considerable weight to the opinions of
        treating physicians unless good cause was shown to the contrary.
        Lewis v. Callahan, 125 F.3d 1436, 1440 (11th Cir. 1997). In 2017, the
        Commissioner issued a regulation providing, “We will not defer or
        give any specific evidentiary weight, including controlling weight,
        to any medical opinion(s) or prior administrative medical find-
        ing(s), including those from your medical sources.” 20 C.F.R. §
        404.1520c(a) (2017). That rule applies to all claims filed on or after
        March 27, 2017, including Spurgeon’s claims.
               Spurgeon acknowledges that the regulation purports to do
        away with the treating-physician rule. But she argues that the So-
        cial Security Administration cannot regulate that rule away be-
        cause the Social Security Act itself imposes the treating-physician
        rule. She points to the statutory requirement that the Commis-
        sioner “make every reasonable effort to obtain from the
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        22-10999                Opinion of the Court                         11

        individual’s treating” providers “all medical evidence” necessary to
        make a disability determination “prior to evaluating medical evi-
        dence obtained from any other source on a consultative basis.” 42
        U.S.C. § 423(d)(5)(B). In Spurgeon’s view, the statutory text, struc-
        ture, history, and purpose of the Social Security Act show that Con-
        gress intended to credit the opinions of treating doctors with spe-
        cial weight. Otherwise, Spurgeon reasons, it would not have re-
        quired the Commissioner to prioritize collecting medical evidence
        from treating providers before evaluating evidence from consulta-
        tive sources.
                The problem for Spurgeon is that we already decided this
        issue and not in her favor. In Harner, we held that, while the Social
        Security Act instructs how medical evidence should be collected, it
        “does not specify how this evidence is to be weighed.” 38 F.4th at
        897. We also noted that we “have never held that the treating-
        physician rule is unambiguously required by the Act.” Id. at 898.
        Ultimately, we held that 20 C.F.R. § 404.1520c (2017) is not mani-
        festly contrary to the Social Security Act. Id. at 897. And we said,
        “Because section 404.1520c falls within the scope of the Commis-
        sioner’s authority and was not arbitrary and capricious, it abrogates
        our earlier precedents applying the treating-physician rule.” Id. at
        896.
                Spurgeon argues we should ignore Harner for two reasons.
        First, the claimant in that case argued that a judicially created treat-
        ing-physician rule applied instead of 20 C.F.R. § 404.1520c (2017),
        while Spurgeon challenges the validity of the regulation itself. But
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        12                         Opinion of the Court                       22-10999

        our resolution of Harner’s appeal necessarily resolved the issue
        Spurgeon raises. After all, we expressly considered whether the
        Social Security Act requires the treating-physician rule and whether
        the regulation abrogates our treating-physician-rule precedents.
               Second, Spurgeon argues that we’ll get a different outcome
        than the Harner panel if we ignore the deference due to administra-
        tive regulations under Chevron, U.S.A., Inc. v. Natural Resources De-
        fense Council, Inc., 467 U.S. 837 (1984). If we ignore Chevron, she
        asserts, the traditional rules of statutory interpretation will show 42
        U.S.C. § 423(d)(5)(B) requires the treating-physician rule. We disa-
        gree for two reasons. First, Chevron remains the governing law.
        And second, even though Harner conducted a Chevron analysis and
        determined the regulation demanded deference, it specifically held
        that “the Act does not specify how [evidence from treating physi-
        cians] is to be weighed” and that “[w]e have never held that the
        treating-physician rule is unambiguously required by the Act.”
        Harner, 38 F.4th at 897–98. We are bound by that holding. And
        that holding forecloses Spurgeon’s arguments to the contrary here.
               Thus, the ALJ did not err by declining to give special weight
        to the opinions of Spurgeon’s treating physician.2

        2 The Commissioner alternatively argues that substantial evidence supported

        the ALJ’s finding that Dr. Perry’s opinion was unpersuasive. We do not con-
        sider this argument because Spurgeon did not raise this issue in either her
        opening or reply brief. See Sepulveda v. U.S. Att’y Gen., 401 F.3d 1226, 1228 n.2
        (11th Cir. 2005) (“When an appellant fails to offer argument on an issue, that
        issue is abandoned.”).
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        22-10999               Opinion of the Court                          13

                   C. Courts can remand on the basis of new evidence only
                     when that evidence is material, and the Nichols Opin-
                                    ion was not material.

                Finally, Spurgeon asks us to reverse the district court’s deci-
        sion and order the matter to be remanded to the Commissioner
        because the Appeals Council did not consider the Nichols Opinion
        and failed to explain why it did not consider the Nichols Opinion.
        The district court held that the Appeals Council did not have to
        consider the Nichols Opinion because it was “inconsistent with the
        record and unsupported by Dr. Nichols’ contemporaneous exami-
        nation,” so it did not “create a reasonable probability that the out-
        come of the proceedings would have changed.” In essence, the dis-
        trict court found that the Nichols Opinion was immaterial.
                But Spurgeon argues on appeal that the district court cannot
        impose its own post hoc reasoning for why the Appeals Council de-
        clined to consider the Nichols Opinion. The Appeals Council never
        said it believed the Nichols Opinion was immaterial, even though,
        Spurgeon asserts, it was required to notify Spurgeon of “why it did
        not accept the additional evidence” under 20 C.F.R. § 404.970(c).
        Even so, we agree with the district court that the Nichols Opinion
        is not material and therefore cannot remand the matter to the
        Commissioner.
               With few exceptions, a claimant may present evidence at
        every stage of the administrative process. Hargress v. Soc. Sec. Ad-
        min., Comm’r, 883 F.3d 1302, 1308 (11th Cir. 2018). “If a claimant
        presents evidence after the ALJ’s decision, the Appeals Council
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        14                     Opinion of the Court                  22-10999

        must consider it if it is new, material, and chronologically rele-
        vant.” Id. at 1309. Whether the evidence meets the new, material,
        and chronologically relevant standard is a question of law subject
        to this Court’s de novo review. Washington v. Soc. Sec. Admin.,
        Comm’r, 806 F.3d 1317, 1321 (11th Cir. 2015) (per curiam). The Ap-
        peals Council commits reversible error when it improperly refuses
        to consider such evidence. Id.
                While Spurgeon agrees we apply de novo review when the
        Appeals Council declines to consider new evidence, she asserts that
        we are barred from passing judgment on whether evidence was
        new, material, or chronologically relevant if the Appeals Council
        failed to do so first. But we think that misses the critical point in
        this case: the Nichols Opinion was submitted after the Appeals
        Council’s deadline for new evidence. So we are not tasked with
        determining whether the Appeals Council erred in refusing to con-
        sider the new evidence. Instead, we must decide if the matter
        should be remanded to the Commissioner to consider that new ev-
        idence in the first instance. And in doing so, we must consider
        whether the evidence is material. We’ll explain.
               Courts can remand Social Security cases to the Commis-
        sioner only under sentence four or sentence six of 42 U.S.C. §
        405(g). Melkonyan v. Sullivan, 501 U.S. 89, 99–102 (1991); Ingram v.
        Comm’r of Soc. Sec. Admin., 496 F.3d 1253, 1261 (11th Cir. 2007).
        “Sentence six of section 405(g) provides the sole means for a district
        court to remand to the Commissioner to consider new evidence
        presented for the first time in the district court[.]” Ingram, 496 F.3d
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        22-10999               Opinion of the Court                        15

        at 1267. And here, because the Nichols Opinion was submitted to
        the Appeals Council more than three months past the deadline for
        new evidence, it was properly presented for the first time in the dis-
        trict court. This means that if Spurgeon’s request for remand is to
        be granted, we would have to do so under sentence six. See Milano
        v. Bowen, 809 F.2d 763, 766 (11th Cir. 1987) (holding it was proper
        to consider remand under the language of sentence six because the
        new evidence was submitted after the Appeals Council’s deadline);
        Ingram, 496 F.3d at 1268 (“We also have held that remand under
        sentence six is appropriate for the Commissioner to consider new
        evidence that the Commissioner did not have an opportunity to
        consider because the evidence was not properly submitted to the
        Appeals Council.”).
               Yet sentence six permits courts to remand matters to the
        Commissioner “only upon a showing that there is new evidence
        which is material and that there is good cause for the failure to in-
        corporate such evidence into the record in a prior proceeding.” §
        405(g) (emphasis added). Put simply, then, federal courts can re-
        mand cases under sentence six only if the new evidence is material.
        So necessarily federal courts must be able to consider whether the
        new evidence is material.
               Still, Spurgeon argues that the Appeals Council was required
        to notify her why it was declining to consider the Nichols Opinion
        under 20 C.F.R. § 404.970(c). And she points to the fact that the
        Appeals Council did not mention the Nichols Opinion in its denial
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        16                     Opinion of the Court                22-10999

        of the request for review and asserts that requires reversal and re-
        mand.
                We disagree for two reasons. First, Spurgeon did not submit
        the Nichols Opinion until well past the deadline for new evidence.
        Spurgeon points to no case or authority requiring the Appeals
        Council to address untimely evidence. And Spurgeon’s proposed
        rule would mean that, even if new evidence was submitted one
        minute before the Appeals Council’s decision came out, the Ap-
        peals Council’s silence on it would require remand. That cannot
        be right. Plus, Spurgeon neither challenges the Appeals Council’s
        ability to impose deadlines for the submission of new evidence nor
        disputes that she submitted the Nichols Opinion late. So the Ap-
        peals Council’s failure to mention evidence submitted after the
        deadline does not, in and of itself, demand reversal and remand.
               Second, 20 C.F.R. § 404.970(c) states, “If you submit addi-
        tional evidence that does not relate to the period on or before the
        date of the administrative law judge hearing decision as required in
        paragraph (a)(5) of this section, or the Appeals Council does not
        find you had good cause for missing the deadline to submit the ev-
        idence in § 404.935, the Appeals Council will send you a notice that
        explains why it did not accept the additional evidence and advises
        you of your right to file a new application.” 20 C.F.R. § 404.970(c).
        The record here makes it clear that Spurgeon was aware of her
        right to file a new application and to seek review in the district
        court, which would have been her options had she disagreed with
        the Appeals Council’s reason for not considering her late-filed
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        22-10999                  Opinion of the Court                             17

        evidence. So even assuming without deciding that the Appeals
        Council violated the notice requirement by staying silent on the
        Nichols Opinion, that error would have been, at worst, harmless
        error.
               Given that circumstance, we consider whether the Nichols
        Opinion is material, even though the Appeals Council did not ad-
        dress the issue. We conclude that it is not.
               New evidence is material when, if accepted, a “reasonable
        possibility” exists that it “would change the administrative result.”
        Washington, 806 F.3d at 1321 (quoting Hyde v. Bowen, 823 F.2d 456,
        459 (11th Cir. 1987)). We’ve concluded in the past that new evi-
        dence was not material when the doctor’s opinion contradicted
        and was inconsistent with other medical records. Hargress, 883 F.3d
        at 1310.
               Here, no reasonable possibility exists that the Nichols Opin-
        ion would change the administrative result. Indeed, the ALJ al-
        ready considered an almost-identical opinion on Spurgeon’s limita-
        tions from Dr. Perry. 3 And the Nichols Opinion suffers from the
        same two deficiencies that Dr. Perry’s opinions did: (1) the Nichols

        3 Dr. Perry and Dr. Nichols listed the same limitations, except that Dr. Perry

        found Spurgeon would be off task for eighty percent of the workday because
        of mental-health issues while Dr. Nichols found she would likely be off task
        for forty-to-fifty percent of the workday. Although the Nichols Opinion also
        diagnosed Spurgeon with obsessive-compulsive disorder, which Dr. Perry did
        not mention in his opinion, the Nichols Opinion does not connect that condi-
        tion to any work-related limitation.
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        18                     Opinion of the Court                22-10999

        Opinion fails to provide any nexus between the conditions in-
        cluded in the report and the listed limitations, and (2) the Nichols
        Opinion’s conclusions are inconsistent with other medical records
        the ALJ considered.
               First, the Nichols Opinion does not explain the basis for the
        enumerated limitations. That’s a problem because we can’t tell
        whether the medical records support the limitations or are other-
        wise consistent with them. Spurgeon argues that the Nichols Opin-
        ion’s conclusions on “absenteeism, time off task, inability to con-
        centrate, and . . . inability to interact with coworkers and supervi-
        sors” would have changed the ALJ’s opinion about Spurgeon’s abil-
        ity to work. For example, the Nichols Opinion concludes that
        Spurgeon “would likely miss 15 or more days in a 30 day period,”
        and the vocational expert opined that consistently missing one day
        of work a month would make someone unable to maintain a job.
        But Dr. Nichols does not explain on what she based her opinion
        that Spurgeon would miss fifteen or more days of work. So we
        don’t know. The same is true for each other conclusion.
               Second, and exacerbating that problem, the ALJ has already
        found the same conclusions that are in the Nichols Opinion to be
        inconsistent with other medical records. The ALJ referenced med-
        ical records showing that Spurgeon was alert, oriented, negative
        for confusion and memory problems, managing her anxiety with
        medication, able to exercise, displaying an appropriate mood and
        intact cognitive function, and receiving unremarkable physical
        findings, among other findings of lack of symptoms. The ALJ
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        22-10999               Opinion of the Court                       19

        found these medical records to be inconsistent with Dr. Perry’s
        conclusions that Spurgeon’s psychological condition would cause
        her to be off task for significant amounts of time and miss ten days
        of work per month. The Nichols Opinion stated the same limita-
        tions but expected even more missed days of work per month,
        without any explanation of what medical evidence supported those
        limitations.
               So as in Hargress, the Nichols Opinion is not material be-
        cause it contradicts other medical records that the ALJ found to be
        persuasive without explaining its basis for doing so. As a result, we
        cannot remand.
                                III.   CONCLUSION

               For the foregoing reasons, we affirm the district court’s de-
        cision upholding the Commissioner’s denial of disability-insurance
        benefits.
              AFFIRMED.