I-3-8-10.Prior Notice to Claimant When Granting Request for Review
Last Update: 4/1/16 (Transmittal I-3-136)
Under 20 CFR 404.973 and 416.1473, when the Appeals Council (AC) decides to grant review in a case, it will mail a notice to all parties at their last known addresses stating the reasons for the review and the issue(s) to be considered.
If the AC is remanding a case to an administrative law judge (ALJ) or issuing a fully favorable decision, the AC will not send prior notice of its action before issuing the final action document.
For cases in the 11th Circuit (Alabama, Georgia, or Florida), the AC must give notice to a claimant when the claimant obtained a partially favorable decision and the AC intends to reopen or review issues not raised by the claimant on appeal. Kennedy v. Bowen, 814 F.2d 1523, 1528 (11th Cir. 1987). Therefore, in the 11th Circuit, the AC will send a “grant review notice-proposal to vacate favorable ALJ decision and remand” notice before remanding unappealed issues ruled on favorably by an ALJ.
B. Notice of Grant Review Action
When the AC grants review and prior notice is required before taking final action (see subsection A above), the analyst will prepare a grant review notice, advising the claimant and the representative, if any, of the AC's proposed finding(s) and action.
The grant review notice will:
State the reason(s) for granting review and the issues to be considered;
Provide the claimant 30 days from the date of the letter to submit any additional evidence or written statement;
Advise the claimant that he or she may request an appearance before the AC; and
When proffering evidence, advise the claimant that he or she may request the case be remanded to an ALJ.
C. Proffering Evidence
When additional evidence is associated with a grant review action, the AC must determine whether the evidence needs to be proffered, using the instructions in Hearings, Appeals and Litigation Law manual I-3-2-16.
D. Preparing Recommendation for AC
When the AC sends a grant review notice (as required by subsection A above), and the time period for comments and submission of additional evidence has expired, the analyst will usually prepare a recommendation for the AC as follows:
If the claimant does not respond to the grant review notice within 30 days, the AC may proceed with the final action.
If the claimant agrees with the proposed action, the AC may proceed with the final action.
If the claimant disagrees with the proposed action but does not request a hearing (when applicable) or the AC did not offer the right to request a hearing, the AC may proceed with its action and address the claimant's reasons for disagreement in its final action.
If the claimant disagrees with the proposed action and requests a hearing when offered, the AC may issue a decision on any issue it can resolve favorably on the claimant's behalf without a hearing and remand any issue that cannot be resolved favorably without a hearing.
In all cases, to prepare the case for release to the AC, the analyst must:
Draft the analysis in the Appeals Review Processing System (ARPS) and complete all other necessary ARPS entries;
Prepare the final action document using the appropriate Document Generation System template;
Proofread the document; and
Send the recommendation and the final action document to the AC for consideration.