I-3-1-1.Overview-Analyst Actions on Requests for Review

Last Update: 10/21/14 (Transmittal I-3-77)

A. Initial Review (Procedural)

The analyst will examine the file to verify that the request for review was filed by a proper party and was timely filed, using the instructions in Hearings, Appeals and Litigation Law (HALLEX) manual I-3-0-60.

The analyst will also determine whether the claim(s) file is complete and ready for substantive review by verifying that:

  • All hearing recording(s) are associated with the claim(s) file;

  • In paper cases, both claim(s) files are present when the case is a concurrent claim;

  • The Office of Appellate Operations has responded to all requests for extensions of time, recordings, or exhibits; and

  • When a representative is involved, the claim(s) file has a valid Form SSA-1696 (Appointment of Representative) or other writing appointing the representative. (For policy on representative appointments, see HALLEX I-1-1-10.)

Before performing a substantive review, the analyst will also evaluate whether the hearing office properly applied the following procedural requirements and whether corrective action is necessary:

  • The hearing office mailed the notice of hearing at least 20 days before the hearing (except in region 1 where notice of hearing is required at least 75 days before the hearing; see HALLEX I-2-3-15);

  • The notice of hearing stated all of the specific issues to be decided;

  • The file contains a claimant's waiver of the right to appear when the administrative law judge (ALJ) did not conduct an oral hearing and issued a less than fully favorable decision (see 20 CFR 404.950(b) and 416.1450(b), Social Security Ruling 79-19, and HALLEX I-2-1-45 F); and

  • The ALJ afforded the claimant proper notice of the right to present evidence or review post-hearing evidence.

NOTE:

See HALLEX I-3-1-25 if the claimant alleges unfairness, prejudice, partiality, bias, misconduct, or discrimination by the ALJ.

B. Substantive Review

When performing a substantive review, the analyst will evaluate the ALJ's action and all information in the claim(s) file (exhibited and non-exhibited). The analyst will also review any contentions submitted by a claimant or appointed representative, if any. When the claimant submits additional evidence, the analyst will determine whether the evidence is new, material, and related to the period at issue, using the instructions in HALLEX I-3-3-6.

The analyst will recommend that the Appeals Council grant review if any of the bases for Appeals Council review noted in HALLEX I-3-3-1 are present.