I-2-1-24.Handling Information Submitted or Associated in a Claim(s) File About a Person Other Than a Party to the Hearing

Last Update: 3/3/25 (Transmittal I-2-268)

A. General

All Office of Hearings Operations (OHO) staff and administrative law judges (ALJs) are responsible for ensuring that the evidence of record properly relates to a party to the hearing. For the definition of “party to the hearing,” see Hearings, Appeals and Litigation Law (HALLEX) manual I-2-1-45. This action is necessary to ensure that the record on appeal contains only evidence actually relied on to make the decision and to avoid inadvertent disclosure of another person's personally identifiable information (PII). For the definition of PII, see the Administrative Instructions Manual System, General Administration Manual, Chapter 15, Instruction No. 01 (AIMS GAM 15.01).

NOTE:

This instruction does not address issues relating to a form SSA-1695, “Identifying Information for Possible Direct Payment of Authorized Fees.” Form SSA-1695, which is now obsolete, has been incorporated into form SSA-1696, “Claimant's Appointment of a Representative.” If OHO receives a form SSA-1695, the instructions in HALLEX I-1-2-95 apply. OHO staff will follow the instructions in Standard Hearings Operation Procedure section 1.3.5.1.

B. Information Inadvertently Associated With the Wrong Claim(s) File

With increased use of electronic services by medical providers, including the electronic submission of evidence to the agency, OHO staff must carefully review the medical evidence to ensure a medical provider did not inadvertently include medical records or other documents related to another individual when sending the claimant's medical records. Additionally, many appointed representatives are now submitting information electronically using fax machines, barcodes, the Electronic Records Express (ERE) system, or by uploading evidence directly to the claim(s) file online through Appointed Representative Services (ARS). When doing so, an appointed representative may inadvertently submit or associate information with the wrong claim(s) file. OHO staff must be diligent in reviewing and associating incoming information to ensure all information is associated with the correct claim(s) file.

When OHO staff discovers information in the wrong claim(s) file, OHO staff must immediately remove that information from the claim(s) file. If an ALJ discovers the issue, the ALJ will not sign a decision or dismissal order until the ALJ has verified staff has removed the information relating to the person who is not a party to the hearing from the claim(s) file.

NOTE:

If OHO staff observes a consistent pattern of a particular appointed representative repeatedly associating information with the wrong claim(s) file, staff will report the issue to the immediate supervisor. It may be appropriate in some instances for OHO staff to contact the representative's office to inform the office of the issue and to remind the representative of the importance of not inappropriately disclosing PII or submitting information that is unrelated to the claimant. If OHO staff believes the circumstances involved demonstrate the representative may have violated our rules, OHO staff will send a referral for possible misconduct using the procedures in HALLEX I-1-1-50.

C. Information About a Person Who Is Not a Party to the Hearing Is Intentionally Submitted

In some cases, a claimant or appointed representative may intentionally submit documents related to a person who is not a party to the hearing as support for consideration of a similar issue. For examples, they may submit information from another claim(s) file to support:

  • A particular finding based on a prior administrative action on the same issue (e.g., a prior remand order involving the same substantive issue);

  • A request for recusal by the ALJ;

  • An alleged pattern of unfairness, prejudice, partiality, bias, misconduct, or discrimination (hereinafter “bias allegation”); and/or

  • An allegation that fraud or similar fault was involved in providing evidence related to their claim.

When a claimant or representative submits supporting information that contains the PII of a non-party to the hearing for one of the reasons described above, the ALJ and assisting staff will associate any written arguments or objections specifically related to the case with the claim(s) file, redact any cited PII in the writing (if not already done so by the claimant or representative), and follow the applicable procedure below.

NOTE 1:

In some situations, the representative may submit information that is not from another claim(s) file, but rather is information specifically about the ALJ, such as statistics about the ALJ's allowance rate or affidavits from representatives with observations about the ALJ. The instructions in subsection C.2. below also apply in this situation.

1. Information Submitted in Support of a Particular Finding

If the claimant or representative submits information about another individual in support of a particular argument, allegation, or proposed finding in the case before the ALJ, the ALJ will not associate the non-party information with the claim(s) file. Instead, the ALJ will either: (1) ensure that staff returns it to the sender; or (2) for submissions that cannot be returned easily, provide the sender with 15 days to pick up the evidence. After 15 days, the evidence will be destroyed. In both situations, the ALJ will also explain in writing:

  • The submitted information relates solely to the case adjudication of another person whose claim is not properly before the ALJ; and

  • The ALJ cannot consider the information as evidence in the claim before him or her.

OHO staff may use a modified version of the sample letter in HALLEX I-2-1-99 for these purposes. The ALJ will ensure that staff associates a copy of the correspondence with the claim(s) file.

NOTE:

If the ALJ already exhibited the information, OHO staff will follow established procedures for removing information that is inadvertently associated with the wrong claim(s) file.

2. Information Submitted in Support of a Recusal Request or Bias Allegation

When considering a recusal request, the ALJ will follow the procedures outlined in HALLEX I-2-1-60 as the facts relate to the particular claim. When an appointed representative submits information from another claim(s) file or with another person's information, or submits other information specifically about the ALJ, for the purpose of alleging a pattern of bias by an ALJ, regardless of whether the ALJ recuses himself or herself in a particular case, the ALJ will inform the representative, in writing, that:

  • The information was [not added to][was removed from] the claim(s) file because it [relates solely to the adjudication of another person whose claim is not properly before the ALJ][is not relevant to adjudication of the particular case before the ALJ];

  • [The information is being returned][The representative has 15 days to pick up the information or it will be destroyed]; and

  • The representative may review Social Security Ruling 13-1p: Titles II and XVI: Agency Processes for Addressing Allegations of Unfairness, Prejudice, Partiality, Bias, Misconduct, or Discrimination by Administrative Law Judges (ALJs) for more information about how the Social Security Administration handles allegations of general bias or a pattern of bias or misconduct by ALJs against a group or particular category of individuals.

For an illustrative sample letter, see HALLEX I-2-1-99. The ALJ will ensure that staff associates a copy of the writing with the record.

3. Information Submitted to Support a Fraud or Similar Fault Allegation

The claimant or the appointed representative might allege that supporting information from a non-party's claim(s) file establishes a particular pattern of fraud or similar fault or misconduct. For example, a claimant may allege that fraud or similar fault is established based on statements from CE providers who were not involved in the pending claim(s), or statements from a CE provider who was involved in the pending claim but that relate to a report provided in a different claim.

If such allegations are based entirely on evidence involving a non-party, the ALJ must inform the claimant and the representative, in writing, that the ALJ cannot consider the allegations of fraud or similar fault because the information does not relate to the claimant or a party to the hearing. The information must be handled consistent with HALLEX I-2-1-24 C.1. above.

OHO staff may use a modified version of the sample letter in HALLEX I-2-1-99 with the following language, as appropriate:

I cannot consider your allegation of fraud or similar fault because the information supporting the allegation(s) does not relate to the claimant or a party before me and is outside the scope of the issues I am adjudicating in this particular case. Under Hearings, Appeals, and Litigation Law (HALLEX) manual I-2-1-24, an administrative law judge may not associate information related to an individual who is not the claimant or a party of the hearing. Therefore, [I did not add the documents to the claimant's claim(s) file] OR [I have removed the documents from the file].

If you would like to submit your allegations directly to the Office of the Inspector General, please visit http://oig.ssa.gov/r or call the Inspector General's Fraud Hotline at 1-800-269-0271 (TTY 1-866-501-2101).

The ALJ will ensure that staff associates a copy of the correspondence with the claim(s) file(s).

Hearing decisions must specifically acknowledge allegations of fraud or similar fault, as explained in HALLEX I-2-10-12. If the allegations are based entirely on evidence involving a non-party, the ALJ will address the allegation of fraud or similar fault in the hearing decision with the following language:

The claimant has alleged that there is reason to believe that fraud or similar fault was involved in the provision of evidence in support of the claimant's application(s). The evidence submitted to support this allegation(s), however, does not relate to the claimant or a party in the hearing before me. This issue is outside the scope of issues I am adjudicating in this claim, and I have not considered this evidence.