I-1-10-10.Hearing Office Procedures When Processing a Subsequent Application After Appeals Council (AC) Action on Prior Application

Last Update: 8/26/13 (Transmittal I-1-67)

A. General

1. AC Directives

While a prior application is pending at the AC level, the hearing office (HO) will not act on the subsequent application until the AC has taken final action. See HALLEX I-1-10-5. In part, HOs do not process these cases because the action taken by the AC may render the subsequent application moot or duplicative.

NOTE:

After the AC takes action on the prior claim, it will notify the HO of the action, as described in HALLEX I-1-10-40.

An administrative law judge (ALJ) may only take action on a subsequent application that is consistent with the AC action. Additionally, an ALJ must comply with any directive from the AC regarding a subsequent application.

2. Acquiescence Rulings (AR)

When drafting a decision for a subsequent application, an ALJ must comply with any relevant ARs addressing consideration of findings in prior final ALJ decisions. As noted in the ARs below, if the claimant resides in the Fourth, Sixth, or Ninth Circuits, the ALJ must adopt prior administratively final hearing decision findings in a subsequent application, unless certain conditions are met.

NOTE:

When the prior hearing decision is pending review before the AC, the prior hearing decision is not final. Adjudicators must be careful not to apply the ARs prematurely.

The applicable ARs are:

  • 4th Circuit (Maryland, North Carolina, South Carolina, Virginia, and West Virginia) – AR 00-1(4): Albright v. Commissioner of the Social Security Administration.

  • 6th Circuit (Kentucky, Michigan, Ohio, and Tennessee) – AR 98-3(6): Dennard v. Secretary of Health and Human Services; AR 98-4(6): Drummond v. Commissioner of Social Security.

  • 9th Circuit (Alaska, Arizona, California, Guam, Hawaii, Idaho, Montana, Nevada, Northern Mariana Islands, Oregon, and Washington) AR 97-4(9): Chavez v. Bowen.

3. Informal Remands

If there is reason to believe that a revised determination would be fully favorable to the claimant, and the action would not be inconsistent with an AC directive, the ALJ may remand the case to the State agency under the conditions in 20 CFR 404.948(c) and 416.1448(c). See also HALLEX I-2-5-12.

B. HO Processing Instructions

1. AC Denial or Dismissal of Request for Review

Upon notification of the AC's denial or dismissal of a request for review, the HO will remove the subsequent application case characteristic, assign the case file for pre-hearing screening, and follow procedures in HALLEX I-2-1-5 to process the request for hearing on the subsequent application based on the date of the hearing request.

2. AC Remand

Upon notification of an AC remand to an ALJ, the HO will:

  • Associate the AC remand order with the pending subsequent application;

  • Review the AC remand order for instructions concerning processing of the subsequent application;

NOTE:

The AC remand order will not always include specific processing instructions regarding a subsequent application. See HALLEX I-1-10-25. This is not a reason to request clarification of a remand order. However, if the AC does not adequately address a subsequent application such that the ALJ cannot carry out the directives set forth in the remand order or the remand directives were rendered moot because of the two applications, the ALJ may request clarification using the procedures in HALLEX I-2-1-85.

  • When instructed, consolidate or associate the claims and close the Case Processing and Management System (CPMS) record for the subsequent application as a technical dismissal using CPMS disposition code “OTDI”;

NOTE:

The ALJ will NOT issue an actual dismissal order.

  • Update CPMS for the remaining claim and follow procedures in HALLEX I-2-1-5 to process the AC remand.

  • When both claims are fully electronic, use the “Join Claims” feature in the eView Status/History tab of the remand to join the remanded and subsequent claims, and

  • Add relevant documents from the subsequent claim to the remanded claim to be exhibited.

3. AC Partially Favorable or Unfavorable Decision

Upon notification of the AC's partially favorable or unfavorable decision, the HO will:

  • Review the AC decision and determine whether it resolves the issue(s) in the subsequent application.

    NOTE:

    An unfavorable AC decision rarely resolves the issue(s) in a subsequent application because an unfavorable AC decision will usually address only the period through the date of the ALJ's decision.

  • If there is no issue(s) to be resolved, close the CPMS record for the subsequent application as a technical dismissal using CPMS disposition code “OTDI.”

    NOTE:

    The ALJ will NOT issue an actual dismissal order.

  • When there is an issue(s) to be resolved, assign the case for pre-hearing screening and follow procedures in HALLEX I-2-1-5 to process the hearing request on the subsequent application based on the date of the hearing request.

4. AC Fully Favorable Decision

Upon notification of an AC fully favorable decision, the HO will:

  • Review the AC decision and determine whether it resolves the issue(s) in the subsequent application.

  • If there is no issue(s) to resolve, close the CPMS record for the subsequent application as a technical dismissal using CPMS disposition code “OTDI.”

    NOTE:

    The ALJ will NOT issue an actual dismissal order.

  • If the subsequent application is a paper case, route the subsequent claim file(s) to the effectuating component for association.

  • If there is an issue(s) that is unresolved, determine the appropriate action in regards to the unresolved issue(s) and apply any other applicable instruction.