I-2-5-13.Claimant Informs the Hearing Office About Evidence

A. General

In a disability or blindness claim under titles II or XVI of the Social Security Act, a claimant must inform the Social Security Administration (SSA) about or submit all evidence known to him or her that relates to whether or not he or she is blind or disabled. This duty is ongoing and requires the claimant to disclose any additional related evidence about which he or she becomes aware (20 CFR 404.1512(a) and 416.912(a)).

At the hearings level, except in a title XVI claim that is not based on an application for benefits, a claimant must generally “inform” SSA about or submit written evidence no later than five business days before the date of the scheduled hearing (see 20 CFR 404.935(a) and 416.1435(a) and Hearings, Appeals, and Litigation Law (HALLEX) manual I-2-6-58 A). If a claimant “informs” SSA about or submits evidence less than five business days before the scheduled hearing, at the hearing, or after the hearing, an administrative law judge (ALJ) may decline to obtain or consider the evidence unless one of the circumstances in 20 CFR 404.935(b) and 416.1435(b) applies (see HALLEX I-2-6-59). See subsection B below for the definition of “inform.”

This section provides hearing office (HO) instructions when a claimant or representative “informs” SSA about written evidence, instead of submitting it, and it explains when SSA may need to assist the claimant in developing written evidence.

B. “Inform” Defined

To satisfy a claimant's obligation under the regulations to “inform” SSA about written evidence, he or she must provide information specific enough to identify the evidence (source, location, and dates of treatment) and show that the evidence relates to his or her medical condition, work activity, job history, medical treatment, or other issues relevant to whether or not he or she is disabled or blind (Social Security Ruling (SSR) 17-4p, Titles II and XVI: Responsibility for Developing Written Evidence).

If a claimant does not provide SSA with information specific enough to allow an ALJ or HO staff to identify the written evidence and understand how it relates to whether or not he or she is disabled or blind, he or she has not informed SSA about evidence, and an ALJ or HO staff will generally not take the steps explained in subsections C and D below (SSR 17-4p).

C. When an ALJ or HO Staff May Need to Assist a Claimant in Developing Written Evidence

When a claimant or representative informs SSA about written evidence, the ALJ or HO staff may need to assist the claimant in developing that evidence if:

• the case involves a title XVI claim that is not based on an application for benefits (416.1435(c));

• the claimant or representative informs SSA about the evidence no later than five business days before the date of the scheduled hearing; or

• the claimant or representative informs SSA about the evidence less than five business days before the date of the scheduled hearing, at the hearing, or after the hearing but before the ALJ issues the decision, and one of the circumstances listed in 20 CFR 404.935(b) or 416.1435(b) applies.

In these cases, an ALJ or HO staff will generally take the following actions:

• The ALJ or HO staff will generally first ask the individual or representative to submit the evidence (see subsection D below).

• If the individual or representative shows that he or she is unable to obtain the evidence despite good faith efforts or for reasons beyond his or her control, an ALJ or HO staff may request the evidence directly from the medical source or entity that maintains the evidence (see subsection E below).

However, if an ALJ or HO management official believes it would be more efficient to request evidence from an identified source, without first asking a claimant or representative to submit it, he or she may do so according to the instructions in subsection E below. For more information, see SSR 17-4p.

D. When SSA Asks the Claimant to Submit the Evidence

In general, when a claimant or representative informs an ALJ or HO staff about evidence but does not submit the evidence and one of the circumstances listed in subsection C above applies, the HO staff will request, either by telephone or in writing, that the claimant or representative submit the evidence. The HO staff must document any telephone conversation related to evidence development on a form SSA-5002, Report of Contact (RC); associate the RC with record; and exhibit the RC.

The HO staff will diary the case for at least 10 days, as appropriate, and wait for the claimant or representative to submit the evidence. If a claimant or representative does not submit the requested evidence by the diary date, HO staff will follow the instructions in subsection E below.

E. When SSA May Help Claimants Obtain the Evidence

If a claimant or representative does not submit the requested evidence by the diary date described in subsection D above, HO staff will contact the claimant or representative, preferably by telephone, to determine why he or she has not submitted the evidence. The HO staff must document any telephone conversation related to evidence development on an RC; associate the RC with record; and exhibit the RC.

If a claimant or representative indicates that he or she needs additional time to submit the evidence (e.g., where a medical source has allegedly promised to provide the evidence within a reasonable period), an ALJ may extend the time for him or her to submit it. If an ALJ agrees to extend the time to submit the evidence, the HO staff will inform the claimant or representative of the extension and diary the case for the time determined by the ALJ.

If a diary date will expire after the scheduled hearing, the HO staff will explain to the claimant or representative that if the ALJ does not receive the evidence by the diary date, unless the ALJ agrees to extend the time to submit the evidence, the ALJ may issue a decision without the evidence.

If an ALJ finds that the claimant or representative has shown that he or she is unable to obtain the evidence despite good faith efforts or for reasons beyond his or her control, the ALJ or HO staff may request the evidence directly from the medical source, non-medical source, or entity that maintains the evidence following the instructions in HALLEX I-2-5-14 (medical evidence) or I-2-5-68 (non-medical evidence), as appropriate. It is generally within the ALJ's discretion to determine what constitutes good faith efforts, and the ALJ may ask the individual or representative appropriate questions regarding what efforts have been made

If an ALJ or HO staff is unable to obtain evidence from a medical source, he or she may also obtain similar information by way of a consultative examination or specific test (see HALLEX I-2-5-20).

F. If a Representative Has a Pattern of Informing SSA About Evidence Instead of Acting With Reasonable Promptness to Help Obtain It

A representative has an affirmative duty to act with reasonable promptness to help obtain the information or evidence that a claimant must submit under the regulations, and forward the information or evidence to SSA for consideration as soon as practicable (20 CFR 404.1740(b)(1) and 416.1540(b)(1); SSR 17-4p).

If a representative has a pattern of informing SSA about evidence instead of acting with reasonable promptness to help obtain and forward the evidence to SSA, an ALJ may consider whether circumstances warrant referral to the Office of the General Counsel (OGC) as a possible violation of our rules. See HALLEX I-1-1-50 for instructions on making referrals to OGC.