Background

This transmittal amends the Hearings, Appeals and Litigation Law (HALLEX) manual chapter I-3-5 to clarify how the Appeals Council (AC) handles new information when the AC has already issued a denial of a request for review. We also made minor changes to how the AC considers additional evidence in a request for review for consistency with current practices.

Explanation of Content and Changes

This transmittal revises I-3-5 as follows:

I-3-5-20 – We added NOTE 1 to clarify that in region 1, the AC will use the rules in Part 405 when evaluating additional evidence. We added a NOTE 2 in subsection A.4. to clarify that when the claim is for title II benefits only and the claimant's insured status has expired, the AC will provide a protective filing date for a new title II claim only if the claimant's date last insured was within two years of the AC's denial notice. We also modified the language in A.5. to reflect current practices for returning evidence.

I-3-5-50 – We retitled the section “Appeals Council Receives Additional Evidence After Issuing Denial of Request for Review” for clarity. We removed all of the information previously in the section and incorporated updated instructions for handling additional evidence received after the AC has denied a request for review. We added subsection A titled “Identifying Additional Evidence After Case Closure” and provided instructions for identifying and handling information received after a case is closed by the AC. We added subsection B titled “Establishing a Case in ARPS” to explain the workload type used to establish a new case in the processing system. We added subsection C titled “Reviewing the Additional Evidence” to set forth the necessary procedures when the evidence was submitted but not associated with the file prior to the AC denial notice. We also explain the procedures if the evidence was submitted on or after the date of the AC denial notice. Finally, we added subsection D titled “Request for Exhibits, Hearing Recording(s), and/or Extension of Time Submitted But Not Associated Prior to Date of Denial Notice” and included the instructions for processing requests for information submitted but not processed before the date of the AC denial notice.

Date: March 25, 2014