I-3-1-23.Requesting Paper Claim(s) File
Last Update: 5/26/17 (Transmittal I-3-157)
A. Locating the Claim(s) File
Office of Appellate Operations (OAO) staff will request a paper claim(s) file upon receipt of a request for review where the official claim(s) file is paper. OAO staff will also obtain a paper claim(s) file when it is needed to respond to a request for copies of material (see Hearings, Appeals and Litigation Law (HALLEX) manual I-3-1-21) or a request for an extension of time to file a civil action (see HALLEX I-3-9-92). Further, OAO staff will request a prior paper claim(s) file when it is needed to fully evaluate the issues before the Appeals Council (AC) (see HALLEX I-3-2-22).
To locate a paper claim(s) file, OAO staff will perform queries to determine possible locations for the claim(s) file (see Program Operations Manual System DI 11005.085).
B. Claim(s) File Located in the Social Security Administration's National Records Center (SSANRC)
If the queries search returns a claim(s) file location of SSANRC, OAO staff will request the claim(s) file through Personal Communications (PCOM) queries by selecting the T2Fld and/or T16Fld macro buttons in the Query Master and following the prompts. If the requested file is not received, OAO staff will follow up by sending an email to ^NRC QAT Action Items.
If a paper claim(s) file is “missing,” see instructions in subsection D below.
C. Claim(s) File Not Located in the SSANRC
1. Request the Claim(s) File
OAO staff will contact and request the claim(s) file from the component holding the claim(s) file.
When the claim(s) file is in a hearing office (HO), OAO staff will request the file by sending an email with the subject line “Request for Paper Claim(s) File” to the general email box of the HO that is in possession of the claim(s) file. In the body of the email, OAO staff will include the claimant's name and social security number, the date of the hearing, and the name of the adjudicator. As necessary, OAO staff will document such actions on the Claim(s) File and Hearing Recording Search Checklist (see HALLEX I-3-1-26). To find an HO's general email address, OAO staff may:
Type ^OHO [region number] into the global address list and locate the appropriate HO. For example, to locate the Boston HO email address, type ^OHO 01 in the global address list and locate the Boston HO; or
Search in the staff listings on the Office of the Chief Administrative Law Judge intranet site.
NOTE 1:
For critical cases, OAO staff will include this information in the email and request that the HO forward the claim(s) file within 10 days.
NOTE 2:
As National Hearing Centers (NHC) process electronic claims only, it should be unnecessary to contact an NHC for a missing paper claim(s) file. However, in the rare circumstance that an NHC needs to be contacted to locate a missing paper claim(s) file, the general email address is OHO OCALJ NHC [name of NHC location].
2. Documenting the Request
After sending the email, OAO staff will add an unhidden remark in the Appeals Review Processing System (ARPS) that documents the date OAO requested the file. OAO staff will also update the ARPS status code to Diary Action Pending (DACP), and diary the case for 14 days (or 10 days for critical cases). For instructions on creating a diary, see the ARPS Training Manual, Module 6 – Case Diary.
NOTE:
Adding a remark in ARPS is very important so that the AC can evaluate what actions OAO staff took to obtain the file before it determines whether a remand for a missing claim(s) file is appropriate.
3. Follow-Up Procedures
If OAO has not received the file after 14 days, OAO staff will send a follow-up email and diary the case for an additional 14 days. For critical cases, if OAO has not received the file after 10 days, OAO staff will make a follow-up call and diary the case for an additional 10 days. If OAO has not received the file after the additional 14 days (or 10 days for critical cases), OAO staff will notify the branch chief (usually via email) that the claim(s) file was not received. OAO staff will continue to search for the claim(s) file by completing the checklist in HALLEX I-3-1-26. The branch chief will ensure that all relevant follow-ups are completed and annotated on the checklist.
If the branch is unable to obtain the claim(s) file after taking all necessary actions, the branch chief will certify that the claim(s) file is lost by completing and signing the checklist, providing the completed checklist to the AC, and adding a remark in ARPS.
The AC must remand a case if the claim(s) file cannot be located, but adjudicators will carefully evaluate whether appropriate measures were taken to obtain a claim(s) file before doing so. Generally, the AC will not remand a case if the checklist is missing or incomplete. Remanding a claim without due diligence in attempting to obtain the claim(s) file causes unnecessary delay for the claimant and an unnecessary workload for OAO in processing second actions and requests for clarification under HALLEX I-2-1-85 and I-3-9-95.
D. Missing Claim(s) File
When queries show an HO sent a paper claim(s) file to OAO, but OAO did not receive the claim(s) file, OAO staff will contact the HO following the same general procedures in subsection C above, but will use the subject line “Missing Paper Claim(s) File” to identify the correct issue. This action is necessary to avoid an unnecessary remand and to save valuable resources.
If OAO is unable to locate the claim(s) file after following these procedures (including the completion of the checklist in HALLEX I-3-1-26), the AC will remand the case and instruct the HO to reconstruct the missing claim(s) file.
NOTE 1:
If the HO notifies OAO that it located the paper claim(s) file after the AC remanded the case, OAO staff will refer HO staff to the request for clarification procedures in HALLEX I-2-1-87.
NOTE 2:
If the claim(s) file is available but the hearing recording is missing or inaudible, see the instructions in HALLEX I-3-1-12.