I-3-2-1.Overview-Analyst Actions on Requests for Review

Last Update: 7/21/23 (Transmittal I-3-194)

A. Initial Review (Procedural)

The analyst will examine the claim(s) file to verify that a proper party timely filed the request for review, using the instructions in Hearings, Appeals and Litigation Law (HALLEX) manual I-3-1-1.

The analyst will also determine whether the claim(s) file is complete and ready for substantive review by verifying that:

  • All hearing recording(s) are associated with the claim(s) file;

  • In paper cases involving concurrent claims, both claims files are present;

  • The Office of Appellate Operations has responded to all requests for recordings or exhibits;

  • When one or more representatives is involved, the claim(s) file has a valid Form SSA-1696 (Claimant's Appointment of a Representative) or other equivalent writing appointing the representative(s) (for policy on representative appointments, see HALLEX I-1-1-10) and the representative information is correct in the Appeals Review Processing System (ARPS) or Office of Appellate Operations Case Processing System (OAOCPS) and the Registration, Appointment and Services for Representatives (RASR) application; and

  • The claimant's address in ARPS or OAOCPS is current and accurate based on review of the queries and the claim(s) file.

The analyst will also examine the claim(s) file for outstanding requests for an extension of time (EOT) to submit additional evidence or arguments. If the analyst discovers such a request, they will determine whether the Appeals Council (AC) should respond to the request before performing a substantive review.

NOTE 1:

The AC may mail an acknowledgement letter that confirms receipt of the claimant's request for review. The acknowledgement letter is not an EOT and should not be used to respond to a request for an EOT.

NOTE 2:

The AC generally will grant an initial EOT request and should respond to such a request before performing a substantive review. However, it is not always necessary for the AC to respond to an EOT request before performing a substantive review. Certain circumstances may render the request moot. As described in HALLEX I-3-1-14, in these circumstances, the AC may address an EOT request with its action on the request for review.

Before performing a substantive review, the analyst will also evaluate whether the hearing office properly applied the following procedural requirements and whether corrective action is necessary:

  • The hearing office mailed the notice of hearing at least 75 days before the hearing, unless the file contains a claimant's written waiver of their right to advance notice (see HALLEX I-2-3-15);

  • The notice of hearing stated all issues to be decided;

  • The claim(s) file contains a claimant's written waiver of the right to appear when the administrative law judge (ALJ) issued a less than fully favorable decision without conducting an oral hearing (see 20 CFR 404.950(b) and 416.1450(b), Social Security Ruling 79-19, and HALLEX I-2-1-82); and

  • The ALJ afforded the claimant proper notice of the right to present evidence or review post-hearing evidence.

NOTE 3:

See HALLEX I-3-2-25 if the claimant alleges unfairness, prejudice, partiality, bias, misconduct, or discrimination by the ALJ.

B. Substantive Review

When performing a substantive review, the analyst will evaluate the ALJ's action and all information in the claim(s) file (exhibited and non-exhibited). The analyst will also review any contentions submitted by the claimant or appointed representative(s), if any. When the claimant submits additional evidence, the analyst will review the evidence using the instructions in HALLEX I-3-3-6.

If any of the bases for AC review noted in HALLEX I-3-3-1 are present, the analyst will recommend that the AC grant review.