Previous Contents Next

I-3-8-22. Release of Files — Fully or Partially Favorable Decision

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

  1. The OAO Branch support staff will forward the claim file and decision for effectuation. Refer to I-3-8-90 for destination codes and addresses and I-3-8-91 (AC Decision Coding Sheet) for coding instructions.

    NOTE:

    The AC Decision Coding Sheet is completed by an analyst when the decision is forwarded to the Appeals Council. In all fully or partially favorable decisions, the analyst will complete both the Regulation Basis Code(s) and Impairment Code(s).

  2. If concurrent Titles II and XVI claims are involved, the analyst must ensure that separate files are prepared and contain the material needed for each claim. (See I-3-8-23, Release of Files — Separating Concurrent Files.)

  3. In addition, if the claimant has filed concurrent Titles II and XVI claims; the claimant lives in Delaware, New Jersey, Pennsylvania, or the Virgin Islands; and the Appeals Council decision is favorable, annotate "Mazza Case" in the remarks section of the HA-505 transmittal. See Acquiescence Ruling 92-1(3), Mazza v. Secretary of Health and Human Services.

  4. If the claimant has a representative, the branch staff will enclose Form SSA-1560-U4, “Petition to Obtain Approval of a Fee for Representing a Claimant Before the Social Security Administration,” with the representative's copies of the transmittal letter and decision, unless there is an approved fee agreement in file. (See I-1-2-31, Fee Agreement - Appeals Council Level — OAO Branch Procedures.)

  5. In favorable situations where the claimant is represented, but the file does not contain a fee agreement, the analyst must annotate the route slip to advise the branch staff to forward the appeals file to the Attorney Fee Branch after release of the Appeals Council decision. The appeals file must contain:

    1. a copy of the Appeals Council decision;

    2. a copy of the ALJ's decision;

    3. OAO's recommendation (original);

    4. Medical Support Staff comments (original);

    5. Administrative Appeals Judge comments (original);

    6. copies of Appeals Council level correspondence to the claimant or representative; and

    7. copies of Appeals Council level correspondence regarding development.

Previous Contents Next