Last Update: 9/2/05 (Transmittal I-2-63)
The ALJ's final decision is binding on the claimant unless:
the claimant requests a review of the decision by the Appeals Council within the stated time period, and the Appeals Council assumes jurisdiction to review the case;
the claimant requests a review of the decision by the Appeals Council within the stated time period, the Appeals Council denies the request for review, the claimant seeks judicial review of the decision by filing an action in a Federal district court, and the court remands or reverses the decision;
the decision is revised by the ALJ or by the Appeals Council under the reopening provisions (see I-2-9ff., Reopening and Revision);
the expedited appeals process is used (see I-2-2-25, Expedited Appeals Process — Constitutionality of Statutory Issues);
the decision is a recommended decision to the Appeals Council; or
in a case remanded by a Federal court, the Appeals Council assumes jurisdiction under the provisions set forth at 20 CFR §§ 404.984, 416.1484.
NOTE:
Hearing Office (HO) staff should never give out information, either verbal or in writing, to a claimant or representative about whether an ALJ has issued a favorable or unfavorable decision. The decision of the ALJ is not final until the he or she has signed the decision and even though the ALJ may have initially directed a decision be favorable or unfavorable, the ALJ may change the decision prior to signing it. By not disclosing to the claimant or representative the decision of the ALJ, prevents an issue from arising where the representative or claimant was told of the decision to have the ALJ change the final decision after such communication.