Last Update: 9/08/05 (Transmittal I-3-36)
A remand order serves two purposes:
The Appeals Council remand order instructs the ALJ what action(s) to take and why the action(s) is necessary; and
The remand order also communicates information to the claimant.
Therefore, in addition to providing precise, comprehensive and accurate information and instructions to the ALJ, it is also necessary to draft language from the claimant's perspective.
Refer to the Appeals Text Guide for remand order shells and stored paragraphs to complete or modify as necessary to reflect the facts of each individual case.
In Title XVI and concurrent Title II/Title XVI remand cases involving medical cessation, the analyst will use DGS to prepare payment status request and transmittal documents to the servicing field office for potential payment continuation (see POMS DI 12027.065). In Title II only cessation cases, the hearing office has responsibility for notifying the servicing field office for potential payment continuation upon receipt of the Appeals Council remand (see POMS DI 12027.060).
The analyst will draft the insert language following these rules:
Focus attention on the decision or dismissal under review, rather than on the ALJ who wrote it. Do not dwell on the ALJ's “failures” or “errors” in such a way that could possibly undermine his or her authority in future dealings with the claimant and the representative.
Refer to the claimant in the third person, e.g., as “the claimant,” rather than in the second person, as the Appeals Council does in denial notices.
Use the active voice.
To the extent possible, use words which are simple and precise.
Omit surplus words.
Use legally correct terms.
To the extent possible, do not use in-house jargon.
Set forth clearly and concisely the reasons for the remand and the instructions for further action. Avoid rationale language that broadly suggests what is required but is not specific enough to help the ALJ.
Specify what evidence is needed and why.
Cite pertinent conflicts in the record.
Follow current instructions on pertinent circuit case law. If the hearing decision did not adequately respond to issues which are of particular concern in that circuit, the analyst must so specify in the remand order.
Identify the new and material evidence which the claimant submitted to the Appeals Council and which is a basis for the remand.
In addition, remember that correct spelling and grammar are important to all readers. Proofread the remand order before forwarding it to the Appeals Council for review.
Appeals Council remand orders are ordinarily assigned to the same ALJ who issued the decision or dismissal (See I-2-1-55).
This policy will not apply when the Appeals Council directs that the case be assigned to a different ALJ; e.g., it is determined that the claimant did not receive a full and fair hearing or it is a second remand.
If the Appeals Council does not order that a hearing be held, the remand order will require the ALJ to offer the claimant an opportunity to appear at a hearing, even when the claimant initially waived an oral hearing.
In Title II disability claims in which the period at issue expired before the date of the hearing decision, the claimant need not be offered the opportunity for a hearing unless the ALJ finds that the facts warrant it.
Forward the file with the recommendation and remand order package (e.g., remand order, cover letter, and route slip) to the Appeals Council for approval.