I-4-3-107.Exhibit - Time-Limited Remand/Delayed Case Form

Last Update: 9/13/05 (Transmittal I-4-15)

Time-Limited Remand/Delayed Case*

  1. Part I (To be completed by analyst)

    Claimant:

    Delayed Case

    Date Court remand order issued _____________________ (enter date)

    Hearing Office _______________________________________ (enter City and State)

  2. (To be completed by analyst designated to call HO to advise of Time Limit/Delayed Case)

    Date call completed _______________________________

    Person contacted: (Check one)

    ____ Supervisory Staff Attorney ____________ (NAME) __________ (PHONE #)

    ____ Hearing Office Director _______________(NAME) __________ (PHONE #)

  3. To be completed by CCPRB Support Staff (person releasing remand)

    Date remand released to ALJ ____________________ (date)

After remand order is released, this sheet should be filed in the Appeals File.

* A delayed case is one which is released to an ALJ more than 125 days after a court remand was issued and includes cases remanded to an ALJ for a second time based on the same court order.