I-4-4-15.Receipt of Additional Evidence (With or Without a Subsequent Claim) — Sufficiency of the Record and Scope of Analyst Review

Last Update: 02/13/17 (Transmittal I-4-66)

The claimant or another Social Security Administration (SSA) component may submit additional materials to the Appeals Council (AC) at any time. The materials may or may not be part of a subsequent claim that has been adjudicated. If the claimant files a subsequent application after commencing a civil action on a prior claim, the adjudicating component (i.e., the Disability Determination Service, an administrative law judge (ALJ), or the AC) will limit its consideration to the period, if any, following the period undergoing judicial review. In title II disability claims, if the decision being reviewed by the court ruled through the date the non-disability requirements were last met, the SSA field office will prepare a technical denial notice and forward any evidence submitted in connection with the subsequent claim to the Office of Appellate Operations (OAO). If the adjudicating component makes a favorable determination or decision on the subsequent application, it will request the effectuating component to forward the case to OAO after effectuation to determine the impact, if any, of the favorable determination or decision on the pending court case.

The analyst will review the claim(s) file or certified administrative record (CAR) and any newly received evidence, contentions or other materials and determine if he or she needs additional information or claim(s) files. If so, the analyst will return the case to the Court Case Preparation and Review Branch (CCPRB) support staff with instructions to obtain the necessary information or files. If the analyst does not need additional information or files, the new material must be reviewed to determine whether it affects the defensibility of the pending court case. Additionally, the analyst must determine whether good cause exists for obtaining remand of the pending court case. See Hearings, Appeals and Litigation Law (HALLEX) I-4-4-20.

For cases in which the adjudicating component has issued a favorable determination or decision on a subsequent claim and forwarded the claim for review, follow the procedures outlined in HALLEX I-1-10.

OAO may receive a subsequent claim for supplemental review in which the court case is no longer pending. If the court affirmed the Commissioner, the CCPRB analyst will forward the subsequent claim and supporting evidence, along with the CAR or claim(s) file to the ALJ who issued the final decision to consider reopening. If the AC issued the final decision, the CCPRB analyst will forward the case to the appropriate OAO branch with a recommendation to the AC regarding reopening. If the court reversed the Commissioner, the CCPRB analyst will return the subsequent claim to the effectuating component with a copy of the court's reversal, if available. Before authorizing the payment of benefits, the effectuating component is responsible for contacting the Office of Program Law in the Office of the General Council to determine whether the reversal will be appealed. If the court remanded the case, the CCPRB support staff will forward the subsequent claim to the office currently working on the remand or the final decision after court remand.