I-3-5-30.Consideration of Legal Arguments or Contentions

Last Update: 12/27/12 (Transmittal I-3-45)

A. Brief Background

Prior to July 20, 1995, the Appeals Council (AC) required analysts to respond directly to the issue(s) raised in contentions. However, due to workload concerns and resource issues, the AC implemented a new initiative on July 20, 1995, suspending the requirement to provide a detailed discussion of additional evidence and provide specific responses to contentions in the denial notice. See HALLEX I-3-5-90. This change in no way lessened the analyst's responsibility to determine whether additional evidence should be considered under HALLEX I-3-3-6, review any contentions, and make an appropriate recommendation to the adjudicator.

In 2012, the AC officially adopted this initiative.

B. Addressing Contentions When a Denial is Appropriate

  1. An analyst must appropriately handle additional evidence and contentions when making a recommendation to an adjudicator. The analyst will follow the procedures in HALLEX I-3-3-6 and I-3-5-20 when processing any additional evidence. Additionally, the analyst will provide a detailed analysis in the Appeals Review Processing System (ARPS) of any specific arguments or contentions. The ARPS analysis should be sufficient to explain to the adjudicator why the Administrative Law Judge (ALJ) hearing decision is supported by substantial evidence.

    NOTE:

    The analyst need not address contentions that are merely general statements, such as "I am disabled" or "The decision is wrong."

  2. Denial notices must:

    • Acknowledge receipt of and exhibit legal arguments or contentions submitted in connection with the request for review.

    • State that the AC considered the arguments presented.

    • Conclude that the information does not provide a basis for changing the ALJ's decision.

  3. Regardless of whether the folder is paper or electronic, the analyst will include a request for review (e.g., Form HA-520, Request for Review of Hearing Decision/Order) in the B section of the folder, and legal arguments or contentions in the E section of the folder.

  4. The analyst will not exhibit a form HA-520, but will exhibit legal arguments or contentions. An exhibit list and accompanying order must be prepared for documents that the AC exhibits.

NOTE 1:

Frequently, a claimant will submit arguments on a form HA-520. Even in this situation, the analyst should not exhibit the form HA-520. However, to ensure the adjudicator is aware of the legal arguments or contentions, the analyst must specifically direct the adjudicator's attention to the form HA-520 in the ARPS analysis. Additionally, the analyst must address any specific legal arguments or contentions included a form HA-520 in his or her ARPS analysis, using the instructions in this section.

NOTE 2:

Paper files are exhibited in the same manner as electronic files. For example, if the AC adds an exhibit in the E section of a paper file that has existing exhibits 1E-7E, the new exhibit should be numbered 8E.