I-3-4-5.No Right to Request Review
Last Update: 2/7/14 (Transmittal I-3-63)
Except as set forth below, the Appeals Council (AC) will not dismiss a request for review based on “no right to request review.” As noted in Hearings, Appeals, and Litigation Law (HALLEX) manual I-3-1-1 C, the claimant, his or her appointed representative (or representative payee), or other third party on behalf of the claimant can file a request for review.
In all cases, unless the claimant has authorized the release of information to the third party in writing (see HALLEX I-1-4-3 E), the AC will not provide the third party with any information relating to the receipt or processing of the request for review.
If the claimant prematurely files the request for review or the AC erroneously establishes a request for review, see the instructions in HALLEX I-3-4-6.
B. Request for Review Filed By Third Party
In most cases, the AC will not need to resolve any issue when a request for review is filed by a third party.
However, the AC may receive a request for review from a third party that suggests the claimant is unaware of the request. In other instances, after being alerted of a request for review, a claimant may explicitly tell the AC that he or she did not request review of the hearing decision and the claimant does not want to pursue review. In these situations, additional action may be required.
1. Claimant Appears Unaware of the Request for Review
When the evidence suggests a claimant may be unaware of the request for review, it will not always be necessary for staff to contact the claimant. Staff and adjudicators must exercise good judgment based on the information in the record when determining whether it is necessary to contact the claimant for clarification. To illustrate, it may be appropriate to contact the claimant if the claimant's neighbor submitted the request for review on behalf of the claimant, and there is nothing showing the claimant knows of the request. However, it may not be necessary to contact the claimant if the request for review was filed by the claimant's parent and the claimant only recently turned 18.
The AC should always contact the claimant for clarification if the hearing level decision was favorable, and it is unclear whether the claimant is aware of the request for review.
a. Contact the Claimant
If circumstances warrant contacting the claimant for clarification, staff will attempt to contact the claimant by telephone or in writing (see sample letter below). Staff will inform the claimant:
A request for review of the administrative law judge (ALJ) decision was filed and by whom (if known).
The AC cannot dismiss a request for review without a writing from the claimant.
If we do not receive a written request to withdraw the request for review, the AC will proceed with the request for review, and the claimant will receive notice of the AC's action in writing.
The AC will not provide any information about the processing of the claim to the individual who submitted the request for review unless the claimant provides written permission or appoints the person as a representative.
Staff will also provide an appropriate fax number and the following mailing address to the claimant:Social Security Administration
5107 Leesburg Pike
Falls Church, VA 22041-3255
If the claimant does not respond to oral or written communications, the AC will continue processing the request for review.
If the claimant indicates the third party is his or her representative, staff must explain to the claimant that before we can recognize the third party as a representative, the claimant must submit a written notice of appointment. See HALLEX I-1-1-10 for more information about what is necessary to appoint a representative.
b. Document the Contact
Staff will record any contacts or attempted contacts on a Form SSA-5002, Report of Contact, and associate the form with the record in the B section of the file.
2. Claimant Explicitly States He or She Does Not Want to Pursue Review
When the claimant explicitly states he or she does not want to pursue the request for review, see the instructions in HALLEX I-3-4-3.
If the claimant verbally indicates he or she does not want to continue with the request for review, it is critical that the claimant understand the AC cannot dismiss a request for review without a written request from the claimant to withdraw the request for review. If the claimant does not submit a writing, the AC must proceed with the request for review.
3. Claimant is Deceased
If the claimant is deceased, see the instructions in HALLEX I-3-4-4. The AC can dismiss a request for review filed by a third party if there is no eligible substitute party to pursue the claim, the AC has no information to show that another person may be adversely affected by the ALJ decision or dismissal, or, for title XVI benefits, there is no interim assistance reimbursement authorization in effect.
C. Exhibit- Sample Letter
On [DATE], the Appeals Council received a request for review of the administrative law judge's [decision or dismissal] in your case. The request was submitted by [NAME], and is currently pending with the Appeals Council.
We are writing to you because it is not clear whether you know that a request for review was filed in your case. If you want to continue with the appeal, you do not need to do anything. We will continue processing the request for review if we do not receive anything in writing from you. We will not provide any information about your appeal to the person who submitted the request for review, unless you give us written permission.
If you want to withdraw the appeal, we need you to tell us in writing that you understand the following information:
If you withdraw your appeal, you may lose benefits or not qualify for benefits at all.
The administrative law judge's decision will be final and binding.
The Appeals Council does not approve all withdrawal requests, so we may not approve your request.
If the Appeals Council approves your withdrawal request, you will receive a notice dismissing your request for review.
Please include your social security number on your statement, and submit the statement to us within 15 days of the date of this letter. If you do not return a written statement, we will continue processing your request for review, and you will be notified in writing of the Appeals Council action in your case.
Our address is:Appeals Council
Office of Disability Adjudication and Review-SSA
5107 Leesburg Pike
Falls Church, VA 22041-3255
You may also fax this information to us at [FAX NUMBER], Attn: [Branch **]
If you have any questions about this information, please call us at 703-605-8000 or Toll Free 1-877-670-2722. Thank you.
Appeals Council, Social Security Administration