Subject: Appeals Council Decisions
In accordance with Social Security Ruling 82-60, OHA procedures require that whenever drug addiction or alcoholism (DA/A) is involved in a favorable title XVI disability decision, the Appeals Council must make a determination whether DA/A was a contributing factor material to the finding of disability. It has long been OHA policy to include a special decisional paragraph to document this determination. We are revising HALLEX to clarify OHA procedures. This will ensure consistency and avoid problems in effectuating favorable title XVI decisions involving DA/A.
This transmittal revises section I-3-812 to include new subsection D. to specify that in favorable title XVI disability cases involving DA/A, the Appeals Council must determine whether DA/A is a contributing factor material to the finding of disability, and if so, the Appeals Council must find that the claimant is a medically determined drug addict or alcoholic. In its decision, the Appeals Council must address the DA/A issue in the rationale and the findings, and include the DA/A decisional language that deals with treatment and representative payee provisions.
Remove from Chapter I-3-800:
I-3-801 General and I-3-803 cont., dated October 30, 1990 (2 pages).
I-3-812 C. cont., dated September 9, 1992 and I-3-820 Appeals Council Administrative Appeals Judge's Actions dated September 28, 1992 (2 pages).
Insert in Chapter I-3-800:
I-3-801 General through I-3-804 Appending PRTF to Decision — Mental Impairment, dated April 9, 1993 (3 pages).
I-3-812 cont., dated April 9, 1993 and I-3-820 Appeals Council Administrative Appeals Judge's Actions, dated September 28, 1992 (2 pages).
Date: April 9, 1993