I-3-7-14.Remand for Other Reasons

Last Update: 9/08/05 (Transmittal I-3-36)

The Appeals Council may remand for other reasons, such as:

A. Work Activity

The Appeals Council may remand to develop work activity and determine whether the claimant engaged in substantial gainful activity during the period he or she was found under a disability. See Appeals Text Guide.

B. Waiver of Recovery of Overpayment

The Appeals Council may remand to develop the issue of waiver of recovery of an overpayment, when the issue was properly before the ALJ but was not resolved and the evidence is insufficient for the Appeals Council to resolve the issue.

C. Insured Status

The Appeals Council may remand to develop the issue of insured status. See Appeals Text Guide.

See I-3-1-14 regarding referral of cases to the Retirement and Survivors Insurance and Supplemental Security Income Branch when there is an earnings discrepancy which may affect insured status or the special disability insured status requirements are not met at any time.

D. Circuit Law

The Appeals Council may remand a case for compliance with circuit law (including applicable Acquiescence Rulings).

E. State Plan

The Appeals Council may remand a case for consideration of cessation of disability under a State plan in Title XVI cases. See Appeals Text Guide.

F. Lost or Inaudible Hearing Recording

When the Appeals Council is considering a request for review and finds that a hearing recording is lost or inaudible, it will grant the request for review and remand the case for an opportunity for another hearing. The remand order will reflect any other reason(s) for remanding the case in addition to the issue of the lost or inaudible recording.

EXCEPTION:

If the Appeals Council is prepared to issue a fully favorable decision, it may do so rather than remand the case for another hearing.

G. Claimant Objects to Decision Issued by ALJ Who Did Not Conduct the Hearing.

When the ALJ who conducted the hearing is unable to issue the decision because he or she leaves the Social Security Administration, dies, etc., another ALJ may issue the decision. Refer to I-2-8-40 for further discussion of when an ALJ who did not conduct the hearing may issue the decision. If the claimant objects to this procedure and if the credibility of testimony or the demeanor of a witness is critical to the decision, the Appeals Council may vacate the decision and remand the case to an ALJ for a supplemental hearing and a new decision. The ALJ will base the decision on the evidence and oral testimony the ALJ receives in connection with the supplemental hearing, as well as the evidence and testimony received in connection with the original hearing.

H. Unfair Hearing Allegations

When a claimant alleges that the hearing was unfair and the record supports the allegation (see I-3-1-25), the Appeals Council will vacate the hearing decision and remand the case to an ALJ for a hearing and decision. The remand order will specify the reasons for remanding the case, including the Council's findings and conclusions concerning the allegation of an unfair hearing as well as any reason(s) unrelated to the unfair hearing issue. The order will also direct that the case be assigned to an ALJ other than the one who conducted the prior hearing. (See I-3-1-25 B. 4. for necessary referrals of the complaint and the Council's findings, and the Appeals Text Guide.)

When the Appeals Council determines that the record does not support an unfair hearing allegation, but is remanding the case for another reason(s), the remand order will specify that the Council considered the claimant's allegation and concluded that the claimant received a fair hearing. (See I-3-1-25 B. 2. for the necessary referral of the complaint and the Council's findings and the Appeals Text Guide.)

I. Mental Impairment Cases

The Appeals Council will remand those cases in which the ALJ has not considered 20 CFR 404.1520a and/or 416.920a despite the clear presence of a medically determinable mental impairment.

J. Following Proffer of Additional Evidence

The Appeals Council will remand for further proceedings when the claimant requests further consideration by an ALJ after the Appeals Council proffers additional evidence. See Appeals Text Guide.

K. Relationship or Dependency

The Appeals Council will remand a case when it is necessary to obtain evidence and/or resolve discrepancies relating to an individual's relationship to and/or dependency on the wage earner.

L. Adversely Affected Individual

The Appeals Council will remand a case to afford the right to a hearing to an adversely affected individual who was not made a party to the prior proceedings. See 20 CFR 404.932 and 416.1432.

M. Income and Resources Issues

The Appeals Council will remand a case when it is necessary to substantiate allegations and resolve discrepancies relating to grant amounts, living arrangements, income, resources, etc., in supplemental security income cases.