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SOCIAL SECURITY ADMINISTRATION
Office of Hearings and Appeals

HALLEX
Volume I

Transmittal No. I-2-27

Chapter: I-2-800

Subject: Administrative Law Judge Decision

Action Notes

In HALLEX Temporary Instruction (TI) I-5-505, Medicare Claims Processing, add the following to the beginning of section VI. A., Routing of Case Files and Tapes:

  • The automated case routing function is now integrated into the Hearing Office Tracking System (HOTS). See I-2-818 B. 10., Routing and Release Procedures, and I-2-845, Hearing Office Tracking System (HOTS) Case Routing.

In TI I-5-505 VI. A. 3. c., Hearing Tapes, strike through the first sentence and add the following:

  • In HIA, HIB and HIP cases, leave the cassette(s) in the Cassette Storage Envelope on the left side of the CF, regardless of whether the ALJ's action is favorable or unfavorable, or whether the CF is being sent to an effectuating component or to OHA Headquarters. See I-2-850, Procedures for Handling Hearing Cassettes, and I-2-890 Exhibits, Exhibit 6, Cassette Handling Desk Guide.

Background

HALLEX I-2-818 B. 10., Routing and Release Procedures; I-2-845, Decision Routing — Automated Case Routing System, and I-2-890 Exhibits, Exhibit 5, COURT REMAND CASE ROUTING, refer to the “Automated Case Routing System” (ACRS) and the “Automated Case Routing System Operator Instructions and Training Guide” (ACRS Guide).

ACRS is no longer a stand alone system. The automated case routing function is now integrated into HOTS. ACRS Guide information, however, is not integrated into the HOTS User Manual. The HOTS User manual provides operational instructions for the Disposition/Routing function but does not provide procedural information for case routing.

HALLEX I-2-850, Procedures for Handling Hearing Cassettes, discusses procedures for handling the hearing cassette(s) in a claim file (CF) when sending the CF to an effectuating component or to OHA Headquarters. This section does not include procedures for handling the hearing cassette(s) in a Medicare CF.

On March 31, 1992, the Acting Chief Administrative Law Judge (ALJ) issued a memorandum informing the hearing offices (HOs) that effective immediately they should not remove the hearing cassette(s) from any Medicare HIA, HIB or HIP coded CF regardless of whether the ALJ's action on the claim is favorable or unfavorable. This procedural change was necessary because the Cassette Library and Appeals Council were experiencing difficulty filing and locating Medicare hearing cassette(s) because of the variety of appellants and control numbers involved.

On February 12, 1993, the Acting Chief ALJ provided the Regional Offices and HOs a revised Cassette Handling Desk Guide which contains the reminder that “In Medicare Part B cases, the carrier hearing officer's hearing cassette stays in the file.” The revised Cassette Handling Desk Guide was incorporated into HALLEX I-2-890 Exhibits, as Exhibit 6.

Explanation of Content and Changes

This transmittal revises I-2-818 B. 10. and 11.; I-2-845; and I-2-890 Exhibits, Exhibit 5, to reflect that the automated case routing function is integrated into HOTS.

It revises I-2-850 to include the Acting Chief ALJ's March 31, 1992 procedural change regarding hearing cassettes in Medicare HIA, HIB and HIP cases, and to clarify the procedures regarding hearing cassettes in other types of cases.

It revises I-2-890 Exhibits, Exhibit 6, to make the desk guide more complete and consistent with the revised procedures in I-2-850.

Remove

Remove from Chapter I-2-800:

I-2-818 B. 9. cont., through I-2-818 C. cont., dated June 30, 1993 (4 pages).

I-2-840 cont., dated June 30, 1993, and I-2-850 B. through I-2-855 cont., dated November 22, 1993 (3 pages).

I-2-890 Exhibit 4 cont., and I-2-890 Exhibits, Exhibit 5, dated June 30, 1993 (2 pages).

I-2-890 Exhibits, Exhibit 6 through Exhibit 7, dated June 30, 1993 (2 pages).

Insert

Insert in Chapter I-2-800:

I-2-818 B. 9. cont., through I-2-818 B. 11. b. cont., dated February 28, 1994, and I-2-818 C. 3., dated June 30, 1993 (4 pages).

I-2-840 cont., through I-2-850 B. 4. cont., dated February 28, 1994 (3 pages).

I-2-890 Exhibit 4 cont., dated June 30, 1993, and I-2-890 Exhibits, Exhibit 5, dated February 28, 1994 (2 pages).

I-2-890 Exhibits, Exhibit 6, dated February 28, 1994, and I-2-890 Exhibits, Exhibit 7, dated June 30, 1993 (2 pages).

Date: February 28, 1994