I-3-2-1.Overview-Analyst Actions on Requests for Review

Last Update: 6/3/21 (Transmittal I-3-179)

A. Initial Review (Procedural)

The analyst will examine the claim(s) file to verify that a proper party timely filed the request for review, using the instructions in Hearings, Appeals and Litigation Law (HALLEX) manual I-3-1-1.

The analyst will also determine whether the claim(s) file is complete and ready for substantive review by verifying that:

  • All hearing recording(s) are associated with the claim(s) file;

  • In paper cases, both claims files are present when the case is a concurrent claim;

  • The Office of Appellate Operations has responded to all requests for recordings or exhibits; and

  • When one or more representatives is involved, the claim(s) file has a valid Form SSA-1696 (Appointment of Representative) or other equivalent writing appointing the representative(s) (for policy on representative appointments, see HALLEX I-1-1-10).

The analyst will also examine the claim(s) file for outstanding requests for an extension of time (EOT) to submit additional evidence or arguments. If the analyst discovers such a request, he or she will consider if the Appeals Council (AC) should respond to the request before performing a substantive review.

NOTE 1:

The AC may mail an acknowledgement letter that confirms receipt of the claimant's request for review. While the acknowledgment letter tells the claimant that the AC will not act on his or her request for review for 25 days, it is not an EOT. The acknowledgment letter should not be used to respond to a request for an EOT.

NOTE 2:

The AC will generally grant an initial EOT request (see HALLEX I-3-1-14), and should respond to such a request before performing a substantive review. However, it is not always necessary for the AC to respond to an EOT request before performing a substantive review. Certain circumstances may render the request moot or redundant. For example, if, at the time the analyst examines the file, the AC has received the additional evidence or arguments mentioned in the EOT request, the EOT request may be moot.

In addition, if, when the analyst examines the file, the AC has already responded to more than one prior EOT request, the unaddressed EOT request may be considered redundant.

In these circumstances, the AC may address an EOT request with its action on the request for review.

If the EOT request is moot, the analyst will add the following language to the action document, modified as appropriate:

“On [Date of Request], a request was made for an extension of time to submit additional evidence and/or argument. These materials have been received and considered.”

If the EOT request is redundant, the analyst will add the following language to the action document, modified as appropriate:

“On [Date of Request], a request was made for an extension of time. We have already responded to more than one prior request for an extension of time. Accordingly, no further extensions are warranted.”

Before performing a substantive review, the analyst will also evaluate whether the hearing office properly applied the following procedural requirements and whether corrective action is necessary:

  • The hearing office mailed the notice of hearing at least 75 days before the hearing (see HALLEX I-2-3-15);

  • The notice of hearing stated all of the specific issues to be decided;

  • The claim(s) file contains a claimant's waiver of the right to appear when the administrative law judge (ALJ) did not conduct an oral hearing and issued a less than fully favorable decision (see 20 CFR 404.950(b) and 416.1450(b), Social Security Ruling 79-19, and HALLEX I-2-1-82); and

  • The ALJ afforded the claimant proper notice of the right to present evidence or review post-hearing evidence.

NOTE:

See HALLEX I-3-2-25 if the claimant alleges unfairness, prejudice, partiality, bias, misconduct, or discrimination by the ALJ.

B. Substantive Review

When performing a substantive review, the analyst will evaluate the ALJ's action and all information in the claim(s) file (exhibited and non-exhibited). The analyst will also review any contentions submitted by the claimant or appointed representative(s), if any. When the claimant submits additional evidence, the analyst will review the evidence using the instructions in HALLEX I-3-3-6.

The analyst will recommend that the AC grant review if any of the bases for AC review noted in HALLEX I-3-3-1 are present.