Chapter: I-3-10
Subject: Fraud, Similar Fault, and Administrative Sanctions
This transmittal amends section I-3-10 of the of the Hearings, Appeals and Litigation Law (HALLEX) manual to update our policies and instructions based on the recission of Social Security Ruling (SSR) 16-1p Titles II and XVI: Fraud and Similar Fault Redeterminations Under Sections 205(u) and 1631(e)(7) of the Social Security Act and SSR 16-2p, Titles II and XVI: Evaluation of Claims Involving the Issue of Similar Fault in the Providing of Evidence, and the publication of SSR 22-1p: Titles II and XVI: Fraud and Similar Fault Redeterminations Under Sections 205(u) and 1631(e)(7) of the Social Security Act and SSR 22-1p: Titles II and XVI: Evaluation of Claims Involving the Issue of Similar Fault in the Providing of Evidence.
I-3-10-1 – In subsection A we added a cross reference to new HALLEX section I-1-3-26 regarding “non-redetermination” cases. In subsection B we updated NOTE 2 based on the new SSRs. We made minor editorial changes for readability throughout the section.
I-3-10-5 – In subsection B.1. we added a third bullet describing when the Appeals Council (AC) may issue a decision to resolve an issue of fraud or similar fault. We also updated this subsection with new guidance based on SSR 22-1p. In subsection B.2., we clarified that the AC cannot deny a case if an individual has not yet had the opportunity to object to the exclusion of evidence based on fraud or similar fault. We made minor editorial changes for readability throughout the section.
Date: June 7, 2022