I-2-5-28.Action Following Receipt of Requested Evidence

Last Update: 4/1/16 (Transmittal I-2-170)

A. General

As outlined in Hearings, Appeals and Litigation Law (HALLEX) manual chapter I-2-5, there are many circumstances in which an administrative law judge (ALJ) may request additional evidence. When requested evidence is received, the ALJ will review the evidence to ensure it is complete, responsive, material, and relevant. See HALLEX I-2-6-58 for a discussion of when evidence is considered “material.”

B. Requested Evidence Is Complete and Responsive

If the requested evidence is material, relevant to the issues of the case, complete, and responsive, hearing office (HO) staff will:

  • Mark the new evidence as a proposed exhibit (see HALLEX I-2-1-15);

  • Prepare and mark the professional qualifications of each source as an exhibit (see HALLEX I-2-1-30); and

  • Review the total record for sufficiency of the evidence and any material conflicts.

C. Requested Evidence Is Incomplete or Unresponsive

When HO staff requested the evidence through a State agency and the evidence is incomplete or unresponsive, the HO staff will follow the procedures in HALLEX I-2-5-14 D.3.

When HO staff requested the evidence directly from a medical source and the evidence is incomplete or unresponsive, HO staff will contact the source again to determine if additional evidence is available. HO staff may contact the source directly or contact the source through the claimant or the representative, if any. HO staff may request assistance from the State agency, if necessary using the procedures in HALLEX I-2-5-14 D.

D. Requested Evidence Is Not Material and Relevant

If evidence requested through a State agency or directly from a medical source is complete and responsive, but is not material and relevant, HO staff will not exhibit the evidence. In paper cases, HO staff will place the evidence in the C section (Temporary) of the claim(s) file.

E. Disclosure of New Evidence Before the Hearing

Before the hearing, the ALJ will give the claimant or appointed representative, if any, an opportunity to review any information the ALJ proposes to exhibit. Additionally, before the hearing, the ALJ (or assisting staff) will proffer prehearing medical or vocational expert interrogatories obtained before the hearing. Proffering this evidence before the hearing allows the claimant to timely object to or present additional questions to the author of the evidence that will be made part of the record. For more information about prehearing proffer, see HALLEX I-2-5-29. An ALJ (or other authorized designee) is not required to proffer evidence if he or she intends to issue a fully favorable decision without a hearing.

NOTE:

If a claimant or appointed representative requests to review all information in the claim(s) file, rather than just the information the ALJ proposes to exhibit, the ALJ will provide an opportunity for the claimant or representative to do so. See HALLEX I-2-1-35.

If the new evidence contains information that may be detrimental to the claimant's health (such as a serious illness of which the claimant and the medical source may not be aware), the ALJ will exercise appropriate discretion to avoid adversely affecting the claimant's medical situation, while proceeding with the actions necessary to protect the claimant's right to due process. See generally HALLEX I-2-7-30 B.

F. Disclosure of New Evidence After the Hearing

If an ALJ receives new evidence after the hearing from a source other than the claimant or representative, if any, and the ALJ proposes to enter the evidence into the record as an exhibit, the ALJ will follow the proffer procedures in HALLEX I-2-7-1, I-2-7-30 and I-2-7-35. See also HALLEX I-2-5-91, I-2-5-92, and I-2-6-99.