I-3-8-10.Separate Notice to Claimant When Granting Request for Review

Last Update: 12/16/20 (Transmittal I-3-176)

A. General

Under 20 CFR 404.973 and 416.1473, when the Appeals Council (AC) grants 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.

NOTE:

If the AC is remanding a case to an administrative law judge (ALJ), issuing a fully favorable decision, or issuing a partially favorable decision and remanding the remaining issues for further proceedings, the AC will not send an interim notice of review before issuing the final action document.

B. Separate Notice of Review

When the AC grants review and an interim notice of review is required before taking final action, the analyst will prepare the notice, advising the claimant and the representative, if any, of the AC's proposed finding(s) and action.

The interim notice of review will:

  • State the reason(s) for granting review and the issues to be considered;

  • Provide the claimant 30 days from the date of the notice 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 the AC grants review and associates additional evidence with that action, the AC must determine whether it needs to proffer the evidence to the claimant, using the instructions in Hearings, Appeals and Litigation Law manual I-3-2-16.

D. Preparing AC's Final Action

When the AC has sent an interim notice of review and the time period for comments and submission of additional evidence has expired, the analyst will prepare a recommendation for the AC to take its final action as follows:

  • If the claimant does not respond to the interim notice of review 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 an opportunity for a hearing, after considering the reasons for the claimant's disagreement, 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 for any issue that cannot be resolved favorably without a hearing.

In all cases, to prepare the final AC action for release, 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 (DGS) template;

  • Proofread the document; and

  • Send the recommendation and the final action document to the AC for consideration.