P filed a claim for disability benefits from D. P had diabetes and was extremely obese. During his hearing P claimed that he could not work because he had to keep his legs elevated for several hours on an eight-hour basis. No medical evidence was submitted. The ALJ denied the claim. P appealed to the Appeals Council for D. As part of his appeal P now submitted a letter from his doctor which stated for the first time that P cannot sit for more than a half-hour at a time. The Council refused review, and the District Court refused to consider the letter because it had not been before the ALJ. P appealed.