I-3-5-50.Appeals Council Receives Additional Evidence After Denial of Request for Review
Last Update: 9/08/05 (Transmittal I-3-36)
Occasionally, the Appeals Council receives additional evidence on a case after it has denied a request for review. The Appeals Council's next action will depend, in part, on when the claimant or the claimant's representative submitted the evidence.
A. Evidence received prior to the date of the Appeals Council's action
When SSA receives evidence prior to release of the denial notice, but it is not associated with the claim file until after the denial notice is released, the Council must consider the claimant's request for review again. If the Council decides that denial of the request for review is still appropriate, the Council will send the claimant an amended denial notice vacating the prior action. The notice will address the additional evidence, and advise the claimant of the right to file a civil action based on the amended notice. This procedure applies to the receipt of briefs and contentions as well as to medical and other evidence. SSA must receive the evidence, in any Social Security office, prior to the date of the Council's action. Before recommending that the Appeals Council vacate its action, the analyst should ascertain from the Court Case Preparation Review Branch (CCPRB) whether a civil action has been filed. See I-4-1-52 D.
B. Evidence received after the Appeals Council's action
If evidence is received by SSA on or after the date of the denial, or in response to the Appeals Council's action, the Council will not vacate its denial of the request for review. The Council will treat the evidence as a request for reopening. See I-3-9 ff.
C. Request for duplicate exhibits and/or recording(s) of the hearing received prior to date of Appeals Council's action
A situation similar to A. above occurs when SSA receives a request for duplicate exhibits and/or recording(s) of the hearing prior to release of the denial notice, but it is not associated with the claim file until after the denial notice is released. In such a situation, the Council must consider the claimant's request for review again.
Such requests will be forwarded to the OAO Branch support staff, who will obtain relevant queries to ensure the duplication had not previously been released and that a civil action had not been filed. If the Branch support staff determines that the exhibits and/or recording(s) had not been released and no civil action had been filed, they will:
Request the claims file from the OAO Mega-site (or other location).
Immediately prepare a COR-40C letter with the electronic signature of the Executive Director.
Date and release the letter to the claimant and/or representative [with the Branch Chief's (or his/her designee's) approval].
Make appropriate inputs to ACAPS [Workload Type=REO, Control Date=date letter was received in the branch, and SCC=TMV).
Update OHA CCS to show that the request for review is pending.
If there is a subsequent application pending at the hearing level, notify the hearing office by fax that the request for review is pending again.
As soon as the claim file is received, the OAO branch staff will process the request for duplicate exhibits and/or recording(s), send the duplicated material to the claimant and/or representative using the appropriate cover letter, and diary the case for potential response from the claimant and/or representative. When additional evidence and/or contentions are received, or the diary matures, the case will be assigned to a hearings and appeals analyst to rework the case. When the final Appeals Council action is released, the OAO Branch support staff will make the appropriate inputs to ACAPS and OHA CCS.