I-2-8-30.Issuing a Disability Decision When a Claim Is Appealed on a Non-Disability Issue

An administrative law judge (ALJ) may review a claim for disability benefits that was denied based on a non-disability factor. In these cases, if the State agency did not make a determination on the issue of disability, the ALJ must review the facts of the case and decide whether to issue a decision on the disability issue.

If the ALJ denies the case based on a non-disability factor, the ALJ will issue a decision on the non-disability issue and will not address the disability issue.

However, if the ALJ finds in the claimant's favor on the non-disability issue, the ALJ will also review the evidence in the record and take one of the following actions:

• If the evidence in the claim(s) file warrants a fully favorable decision on the disability issue, the ALJ will issue a decision addressing all issues, including disability.

• If the evidence in the claim(s) file does not warrant a fully favorable decision on the disability issue, or if there is insufficient evidence to make a finding on the disability issue, the ALJ will issue a favorable decision on the non-disability issue, but will specifically state in the decision that he or she is not making a finding on the disability issue. Rather, the ALJ will explain he or she is returning the case to the State agency for a disability determination.