I-3-6-1.Notifying Claimant of Granting Request for Review

Last Update: 9/08/05 (Transmittal I-3-36)

A. General

When the Appeals Council grants a request for review, it notifies the claimant and representative, if any, of the action before it issues its disposition.

EXCEPTION:

The Appeals Council does not send prior notice of granting review when:

  • it issues a fully favorable decision, because it would serve no useful purpose and would delay payment of benefits; or

  • it issues a remand order.

NOTE:

For cases in the 11th Circuit, it is the policy of the Appeals Council to send a propose-to-remand letter before remanding unappealed issues ruled on favorably by the Administrative Law Judge (ALJ).

B. Grant Review Notices When Prior Notice Is Required

  1. When the Appeals Council grants review to issue a less than fully favorable decision, the analyst will prepare for the Council's consideration a grant review notice to the claimant with a copy to the representative advising them of the Council's proposed findings.

  2. The grant review notice provides the claimant a period of 30 days within which to submit any additional evidence or further written statement. The notice also advises that the claimant may request an appearance before the Appeals Council or, when non-procedural evidence is being proffered, may request that the case be remanded to an Administrative Law Judge. (See the Appeals Text Guide.)

C. Disclosure of Evidence

  1. The claimant has the right to see and examine the evidence that the Appeals Council proposes to admit into the record. Before the Council makes any additional evidence part of the record, the Council must disclose the evidence to the claimant, allow the claimant the opportunity to examine the evidence, comment on it, and refute it by submitting other evidence.

  2. The Appeals Council may proffer evidence directly to an unrepresented claimant unless the evidence includes a medical report containing language which may be offensive or detrimental to the claimant's health. If an analyst believes that a medical report contains such language, the analyst must discuss the matter with the branch chief.

  3. See the Appeals Text Guide for appropriate language and stored paragraphs for use with Appeals Council grant review, own motion and reopening notices.

D. Typing and Proofreading

To prepare the case for release to the Appeals Council, the analyst must:

  1. Prepare the grant review notice;

  2. Proofread the typed document, and, if it is accurate;

  3. Forward the file with the grant review notice and analysis to the Appeals Council for consideration.