I-3-10-12.Evaluating Allegations of Fraud or Similar Fault by the Claimant or Representative

A. Addressing Allegations of Fraud or Similar Fault

Adjudicators at all levels of the administrative review process are responsible for taking all appropriate steps to resolve similar fault issues in accordance with the standards in Social Security Ruling 22-2p: Titles II and XVI: Evaluation of Claims Involving the Issue of Similar Fault in the Providing of Evidence.

1. If a claimant or representative alleges fraud or similar fault was involved in the providing of evidence, Office of Appellate Operations (OAO) staff and adjudicators will follow Hearings, Appeals, and Litigation Law (HALLEX) manual I-1-3-15 and I-3-10 to ensure the allegation(s) was properly evaluated.

2. In reviewing hearing level decisions containing allegations of fraud or similar fault, OAO staff and adjudicators will evaluate whether the Office of Hearing Operations (OHO) followed the procedures outlined in HALLEX I-2-10-12 and I-2-1-33.

3. OAO staff and adjudicators will refer new claimant or representative allegations of fraud or similar fault consistent with HALLEX I-3-2-31 B.1.

B. Addressing Allegations of Fraud or Similar Fault Based on Information Related to Another Party

The claimant or representative may allege that supporting information from a non-party's claim(s) file establishes a particular pattern of fraud or similar fault or misconduct. In these circumstances, OAO staff and adjudicators will follow the instructions in HALLEX I-3-2-24 C.3.

If the Appeals Council (AC) finds a hearing decision relied on inadmissible information to support a fraud or similar fault finding, the AC will generally grant review due to an “error of law” (HALLEX I-3-3-3).