Background

This transmittal amends Hearings, Appeals and Litigation Law (HALLEX) manual chapter I-2-5 to clarify policy for the consideration of evidence at the hearing level based on the final rule published in the Federal Register at 81 FR 90987. The new rule establishes nationally consistent procedures for case processing at the hearing and Appeals Council levels of review and remove the regulations in 20 CFR Part 405. The transmittal also clarifies procedures for the evaluation of medical evidence based on the finals rules published in the Federal Register at 82 FR 5844.

Explanation of Content and Changes

I-2-5-1 – We update the citations to 20 CFR 404.1512 and 416.912 based on the final rules for the evaluation of medical evidence. In addition, we explain that an administrative law judge (ALJ) may decline to obtain or consider evidence if a claimant informs the Social Security Administration (SSA) about evidence or submits the evidence less than five business days before the date set for the hearing, or after the hearing, unless the circumstances in 20 CFR 404.935(b) and 416.1435(b) apply. In new Note 3, we explain that the business day is a weekday excluding Federal holidays and ends after 11:59pm in the time zone where the hearing office servicing the claimant's address is located. We also add a reference to HALLEX I-2-5-13 for when a claimant informs SSA of additional evidence and a reference to new HALLEX section I-2-6-59 for how ALJs will consider evidence submitted later than five business days before the date of the scheduled hearing. In Note 4, we explain how the new rules affect title XVI cases other than those based on an application for benefits (e.g., age 18 redeterminations, continuing disability reviews, and terminations), the ALJ will accept any evidence submitted on or before the date of the hearing decision. We also make a minor editorial change.

I-2-5-13 – In subsection A, we clarify that an ALJ may decline to obtain or consider evidence if a claimant informs SSA about evidence or submits evidence less than five business days before the date of the scheduled hearing, or after the hearing, unless the circumstances in 20 CFR 404.935(b) and 416.435(b) apply (see HALLEX I-2-6-58 and I-2-6-59). We provide a reference to the definition of “business day.” We add Note 1 to clarify that an ALJ will admit evidence into the record when it is received if a claimant or appointed representative informs SSA about evidence no later than five business days before the scheduled hearing date or the ALJ finds the circumstances in 20 CFR 404.935(b) and 416.435(b) apply. We explain how the new rules affect title XVI cases other than those based on an application for benefits (e.g., age 18 redeterminations, continuing disability reviews, and terminations). We also add Note 2 to describe and cite a representative's duty to act with reasonable promptness to obtain and forward evidence provide the procedures for referring a representative to the Office of the General Counsel if it appears that there is a pattern of informing SSA about evidence instead of acting with reasonable promptness to obtain and forward the evidence. We also add a reference to the procedures for granting an extension of time to submit evidence after the hearing. In subsection B, we clarify when an ALJ or hearing office staff will make every reasonable effort to obtain evidence. In addition, we make minor editorial changes.

I-2-5-78 – We remove citations to the Part 405 regulations, update the requirement to submit a subpoena request at least ten business days before the date of the scheduled hearing, and add Note 1 in B.1. to provide a reference to the definition of “business day.” We also make minor editorial changes.

Date: May 1, 2017