I-3-10-9.Appeals Council (AC) Referrals to the Office of the Inspector General

Last Update: 5/13/14 (Transmittal I-3-65)

When the AC suspects fraud or a criminal violation by a representative, employee, contractor, claimant, or other member of the public, and the issue is not before the AC on review, the AC will use the applicable instructions in Hearings, Appeals and Litigation Law (HALLEX) manual I-1-3.

However, if an issue of fraud or similar fault is first raised or identified during AC review in a disability case, the AC may use the referral instructions in HALLEX I-1-3-21. The AC will then use the applicable instructions in HALLEX I-3-10 to process the issue.

NOTE:

Though the Cooperative Disability Investigation Units (CDIU) generally investigate only disability issues, if an issue of fraud or similar fault arises during case adjudication in a non-disability case, the AC may use the same general referral procedures in HALLEX I-1-3-21. If necessary, the CDIU will transfer the issue to the Office of the Inspector General.