I-3-7-14.Other Common Reasons for Remand
Last Update: 4/26/16 (Transmittal I-3-139)
A. Work Activity
When necessary, the Appeals Council (AC) will remand a case to an administrative law judge (ALJ) to develop the claimant's work activity and determine whether the claimant engaged in substantial gainful activity during a period in which he or she was found to be under a disability.
B. Waiver of Recovery of Overpayment
When a waiver of recovery of an overpayment issue was properly before the ALJ but was not resolved, and the evidence is insufficient for the AC to resolve the issue, the AC will grant review and may remand the case to an ALJ to develop the issue.
C. Insured Status
If the issue of insured status cannot be resolved by the AC, the AC will remand a case for more development of the issue.
D. Acquiescence Rulings
The AC will grant review and may remand a case if an ALJ did not comply with an applicable Acquiescence Ruling.
E. State Plan
When necessary, the AC will remand a case for consideration of cessation of disability under a State plan in title XVI cases.
F. Missing Claim(s) File or Lost or Inaudible Hearing Recording
When the AC is considering a request for review and finds that a claim(s) file is missing, or that a hearing recording is lost or inaudible, it will first follow the procedures in Hearings, Appeals and Litigation Law (HALLEX) manual I-3-1-12 and I-3-1-23. If the AC is unsuccessful in resolving the issue, it will grant the request for review and remand the case.
G. Claimant Objects to Decision Issued by ALJ Who Did Not Conduct the Hearing
When the ALJ who conducted the hearing is unavailable to issue the decision, the hearing operation will follow the instructions in HALLEX I-2-8-40. If the claimant objects to how the issue was handled and the AC determines the reason(s) for the objection raises a due process issue, or the AC determines the evaluation of hearing testimony or observation of the demeanor of a witness is critical to the outcome of the decision, the AC will grant review and may remand the case to an ALJ for a supplemental hearing and a new decision.
H. Unfair Hearing Allegations
When a claimant alleges the hearing was unfair and the record demonstrates that the ALJ abused his or her discretion, the AC will grant review, and, when remand is appropriate, remand the case to a different ALJ. See generally HALLEX I-3-2-25 and I-3-3-2.
I. Mental Impairment Cases
The AC will grant review and may remand a case if the ALJ did not properly evaluate the claimant's mental impairment(s) under 20 CFR 404.1520a and 416.920a, despite the clear presence of a medically determinable mental impairment.
J. AC Proffer of Additional Evidence
The AC will grant review and remand for further proceedings when the AC proffers additional evidence and offers the opportunity to request a supplemental hearing, and the claimant submits such a request. See HALLEX I-3-2-16. Additionally, the AC will grant review and may remand a case when the ALJ does not adhere to proffer procedures. See HALLEX I-3-2-17.
K. Relationship or Dependency
The AC will grant review and may remand a case when it is necessary to obtain evidence or resolve discrepancies relating to an individual's relationship to or dependency on the wage earner.
L. Adversely Affected Individual
The AC will remand a case to provide the opportunity for a hearing to an adversely affected individual who was not made a party to the prior proceedings. See 20 CFR 404.932 and 416.1432. For the definition of a party to the hearing, see also HALLEX I-2-1-45.
M. Income and Resources Issues
The AC will grant review and may remand a case when it is necessary to substantiate allegations and resolve discrepancies relating to grant amounts, living arrangements, income, resources, or other related issues in supplemental security income cases.