I-2-5-13.Claimant Informs Hearing Office of Additional Evidence

Last Update: 5/1/17 (Transmittal I-2-198)

A. General

A claimant must inform the Social Security Administration (SSA) about or submit all evidence, in its entirety, known to him or her that relates to whether or not he or she is blind or disabled. See 20 CFR 404.1512 and 416.912. At the hearings level, a claimant must generally inform SSA about or submit evidence, as required in 20 CFR 404.1512 and 416.912 no later than five business days before the date of the scheduled hearing. If the claimant informs SSA about or submits evidence less than five business days before the scheduled hearing, at, or after the hearing, the administrative law judge (ALJ) may decline to obtain or consider the evidence, unless the circumstances in 20 CFR 404.935(b) and 416.1435(b) apply (see Hearings, Appeals and Litigation Law (HALLEX) manual I-2-6-58 and I-2-6-59). Subject to these rules, when a claimant informs SSA about evidence, we will make necessary attempts, as referenced in this section, to obtain the evidence. For the definition of business day, see HALLEX I-2-5-1 NOTE 3.

NOTE 1:

If a claimant or appointed representative informs SSA about evidence no later than five business days before the scheduled hearing date or the ALJ finds the circumstances in 20 CFR 404.435(b) and 416.1435(b) apply, the ALJ will accept and consider the evidence when it is received.

However, in title XVI cases other than those based on an application for benefits (e.g., age 18 redeterminations, continuing disability reviews, and terminations), if the claimant informs SSA about the evidence at any time on or before the date of the hearing decision, the ALJ will make necessary attempts, as referenced in this section, to obtain the evidence and admit the evidence into the record when it is received. See 20 CFR 416.1435(c).

NOTE 2:

A representative may inform SSA about evidence that relates to whether or not the claimant is blind or disabled (20 CFR 404.935 and 416.1435). However, a representative also has an affirmative duty to act with reasonable promptness to help obtain the information or evidence that the claimant must submit under the regulations, and forward the information or evidence to SSA for consideration as soon as practicable (20 CFR 404.1740(b)(1) and 416.1540(b)(1)). If a representative has a pattern of informing SSA about evidence that relates to the claim instead of acting with reasonable promptness to help obtain and forward the evidence to SSA, an ALJ will consider whether circumstances warrant a referral to the Office of the General Counsel (OGC) as a possible violation of our rules. See HALLEX I-1-1-50 for instructions on making referrals to OGC.

If after the hearing a claimant or appointed representative requests additional time to submit evidence, the ALJ will evaluate the request using the procedures in HALLEX I-2-7-20.

B. Procedures to Develop Evidence When Claimant Informs Hearing Office (HO) of Additional Evidence

When a claimant informs an ALJ or HO staff about additional evidence but does not submit the evidence, the ALJ or HO staff will make every reasonable effort to obtain the evidence using the procedures in this HALLEX section if:

  • The claimant informed SSA about the evidence no later than five business days before the date of the scheduled hearing;

  • The ALJ finds that the claimant missed the five-day deadline but the circumstances in 20 CFR 404.935(b) and 416.1435(b) apply (see HALLEX I-2-6-58 and I-2-6-59); or

    NOTE:

    An ALJ will follow the procedures in HALLEX I-2-6-59 B to determine whether the circumstances in 20 CFR 404.935(b) and 416.1435(b) apply. If the ALJ finds that the circumstances do not apply, the ALJ will follow the procedures in HALLEX I-2-6-59 C.

  • The case involves a title XVI claim that is not based on an application for benefits (e.g., age 18 redeterminations, continuing disability reviews, and terminations).

To make every reasonable effort to obtain evidence, the ALJ or HO staff will first request that the claimant or representative submit the evidence. If necessary, the ALJ or HO staff will provide the claimant or representative with form SSA-827, Authorization To Disclose Information To The Social Security Administration (SSA), to facilitate obtaining the evidence. See HALLEX I-2-5-14 A.

1. Medical Evidence

If the evidence identified by the claimant is medical evidence, HO staff will diary the case for 30 days and wait for the claimant or representative to submit the evidence. If the claimant or representative does not submit the requested evidence by the diary date, HO staff will contact the claimant or representative, preferably by telephone, to determine why he or she has not submitted the evidence and then consult with the ALJ. Depending on the claimant or representative's reason(s) for not providing the evidence, the ALJ may:

  • Extend the time for the claimant or representative to provide the evidence (e.g., if the claimant or representative indicates that a medical source has promised to provide the evidence within a reasonable period);

  • Request the evidence from the identified medical source, either directly (see HALLEX I-2-5-14 B) or through the State agency (see HALLEX I-2-5-14 C); or

  • Obtain similar information by way of a consultative examination or specific test (e.g., if the claimant or representative informs the ALJ that the requested evidence is not available). See HALLEX I-2-5-20.

HO staff will document all attempts to obtain the evidence on a form SSA-5002, Report of Contact (RC), and associate the RC with the record. The ALJ will exhibit RCs relating to developing evidence.

2. Non-Medical Evidence

If the evidence identified by the claimant is non-medical evidence, HO staff will diary the case for 15 days for the claimant or representative to submit the evidence. If the claimant or representative does not submit the requested evidence by the diary date, HO staff will contact the claimant or representative, preferably by telephone, to determine why he or she has not submitted the evidence and then consult with the ALJ. Depending on the claimant's or representative's reason(s) for not providing the evidence, the ALJ may:

  • Extend the time for the claimant or representative to provide the evidence (e.g., if the claimant or representative indicates that a source has promised to provide the evidence within a reasonable period); or

  • Request the evidence directly from the identified source (see HALLEX I-2-5-68).

HO staff will document all attempts to obtain the evidence on an RC and associate the RC with the record. The ALJ will exhibit RCs relating to developing evidence.