I-3-2-60.Single or Separate Final Action Documents for Claims With the Same or Different Titles

Last Update: 9/10/21 (Transmittal I-3-181)

A. Introduction

When preparing a case recommendation, there will be situations where the Appeals Council (AC) will:

  1. take different actions on the same title, or different actions on concurrent claims with a common issue(s) in the claims;

  2. take different actions on concurrent claims that involve different titles with no common issues in the claims, commonly referenced as “split actions;” or

  3. take one action on different claims filed under the same title of the Social Security Act with a common issue(s) in the claims (see Hearings, Appeals and Litigation Law manual I-2-2-22).

B. Remand and Decision on the Same Title in Single or Concurrent Claims

1. General

In some cases, the AC intends to issue a decision for part of the period at issue and remand for an administrative law judge's consideration of the remaining period at issue.

Since the AC is taking different actions on the same title or more than one title in concurrent claims, it will issue two separate action documents with each document addressing a different action.

NOTE:

This situation does not occur when affirming a portion of a decision or determination, and that can be addressed in one action document.

2. Preparation of Notices

The analyst will prepare both action documents using the eSign workaround process. Each action document should also include language describing the separate actions.

Depending on the scenario, the following language should be added to the remand:

“Under a separate notice, the Appeals Council is issuing a partially favorable decision finding the claimant disabled beginning on [date AC finds disability began].”

OR

"Under a separate notice, the Appeals Council is issuing a partially favorable decision finding the claimant disabled from [date AC finds disability began] to [the last date of disability].

Depending on the scenario, the following language should be added to the partially favorable decision:

“For the reasons set forth in the decision, the Appeals Council finds the claimant is disabled beginning [date AC finds disability began], and remands the case under a separate notice to an Administrative Law Judge for further proceedings for the period prior to that date (20 CFR 404.973 and/or 416.1473).”

OR

“For the reasons set forth in the decision, the Appeals Council finds the claimant is disabled from [date AC finds disability began] to [the last date of disability], and remands the case under a separate notice to an Administrative Law Judge for further proceedings for the remaining period(s) at issue (20 CFR 404.973 and/or 416.1473).”

3. Appeals Review Processing System Inputs and eView Alerts

In the Appeals Review Processing System (ARPS), it is important that the cases are coded correctly because different actions are being taken on the same title. In ARPS, analysts will enter the final recommendation as a remand.

The analyst should add a Support Staff Instruction remark in ARPS indicating that two action documents need to be released manually. If the case has a certified electronic folder, a similar message should be added to the Alerts and Messages tab in eView. The analyst should also add a To-Do Item. For example, the analyst should make the following selections: Item - Other Pending Case Action; Information - See ARPS remark (Two action documents); Due Date - default date; Employee - unassigned.

When closing the cases, support staff should review the Remarks and To-Do Items and release both action documents manually at the same time.

4. Support Staff Release and Case Closure Instructions

For a case in a Disability Processing Branch that has a certified electronic folder, support staff should take the following actions before closing the case in ARPS:

  • Print the two action documents, date both the same day, mail both (Central Print should not be used to release the action documents), and upload both to eView.

  • Notify the proper effectuation component. For title II claims, use the Evidence Portal, attaching a copy of the decision to notify the Payment Center. For title XVI claims, email or fax a copy of the decision to the appropriate field office WorkTrack number in the Detailed Office/Organization Resource System, also known as DOORS.

  • Complete any other necessary steps to close the case in ARPS. When the records in ARPS are closed with the Remand disposition code, the appropriate Servicing Hearing Office will receive notice that a Remand has been issued.

If it is a paper claim(s) file, support staff should take the following actions before closing the case:

  • Print the two action documents, date both the same day, and mail both.

  • Prepare a duplicate claim(s) file (two duplicate files in concurrent cases with one going to the Payment Center and the other to the Field Office).

  • Mail the duplicate claims(s) file to the effectuating component(s), along with the AC's final action documents, clearly indicating on the transmittal sheet that this is a combined Decision-Remand and that effectuation of the decision is necessary.

  • Mail the original paper claim(s) file to the servicing hearing office, along with the AC's final action documents, clearly indicating on the transmittal sheet that this is a combined Decision-Remand and that action regarding the remand is necessary.

  • Complete any other necessary steps to close the claim(s) in ARPS.

C. Split Actions

1. General

Split actions most frequently occur when the AC intends to issue different actions on a claim that involves more than one title, but there is no common issue(s) between the claims. The situation may also occur when the AC intends to issue different actions on multiple claims under the same title, and there is no common issue in the claims. Examples of these situations include when the AC issues the following:

  • Dismissal and Remand;

  • Dismissal and (Fully Favorable, Partially Favorable, or Unfavorable) Decision;

  • Dismissal and Denial;

  • Denial and Remand;

  • Denial and (Fully Favorable, Partially Favorable, or Unfavorable) Decision; or

  • Remand and (Fully Favorable, Partially Favorable, or Unfavorable) Decision.

2. Preparation of Notices

Since the AC is taking different actions on the separate titles with no overlapping period of time and no common issues, the analyst will prepare multiple action documents with each document addressing the respective title(s).

The analyst will prepare the action documents using the eSign workaround process. Each action document should also include language in the notice that indicates the AC is issuing a separate action addressing the other title(s). For example, the notice should contain the following language with the appropriate title selections made:

“This notice relates to the claim for [title II/title XVI] benefits. The Appeals Council is issuing a separate notice in the claim for [title II/title XVI] benefits.”

3. ARPS Inputs and eView Alerts

In ARPS, enter the appropriate recommended final actions on the separate titles reflecting the different actions (e.g., title II: Dismissal - Withdrawal (WDDI) and title XVI: Favorable Decision (FAVD)). The analyst should add a Support Staff Instruction remark in ARPS regarding releasing the two action documents when closing the case. The analyst should also add a To-Do Item. For example, the analyst should make the following selections: Item - Other Pending Case Action; Information - Two action documents see ARPS remark; Due Date - default date; Employee - unassigned.

4. Support Staff Release and Case Closure Instructions

When closing the cases, support staff should:

  • Review the Remarks and To-Do Items;

  • Print the multiple action documents, date both the same day, and mail both (Central Print should not be used to release the action documents); and

  • Take any other necessary steps to close the claims in ARPS.

D. Same Title With Multiple Claims and Common Issue in the Claims

This situation occurs when the claimant files multiple (two or more) claims with a common issue(s) under one title. For example, a claimant files title II claims for disability insurance benefits (DIB) and disabled widow(er) benefits (DWB); files a claim for DIB and child disability benefits (CDB); or files concurrent claims for disability insurance benefits and supplemental security income (SSDC) and a claim for DWB or CDB.

  • If the AC takes the same action on the claims, one action document should be prepared to address the claims (see prior sections if taking different actions).

  • These claims, however, should have multiple records established in ARPS.

  • When making this type of recommendation, the analyst should add a Support Staff Instruction remark in each of the multiple ARPS records indicating there is one action document, listing which record it is associated with, and explaining the number of multiple ARPS records that need to be closed. The analyst will also add a To-Do Item. For example, the analyst should make the following selections: Item - Other Pending Case Action; Information - Two ARPS records see ARPS remark; Due Date - default date; Employee - unassigned.

  • The e-Sign action document will be associated with the claim that matches the claim type selected in the Document Generating System.

  • When closing the cases, support staff should review the Remarks and To-Do Items, release one action document, close the multiple ARPS records, and take any other actions necessary to close the claims.