Chapter: I-2-10
Subject: Fraud, Similar Fault, and Administrative Sanctions
This transmittal amends section I-2-10 of the of the Hearings, Appeals, and Litigation Law (HALLEX) manual to update our policies and instructions based on the recission of Social Security Ruling (SSR) 16-1p Titles II and XVI: Fraud and Similar Fault Redeterminations Under Sections 205(u) and 1631(e)(7) of the Social Security Act and SSR 16-2p, Titles II and XVI: Evaluation of Claims Involving the Issue of Similar Fault in the Providing of Evidence, and the publication of SSR 22-1p: Titles II and XVI: Fraud and Similar Fault Redeterminations Under Sections 205(u) and 1631(e)(7) of the Social Security Act and SSR 22-2p: Titles II and XVI: Evaluation of Claims Involving the Issue of Similar Fault in the Providing of Evidence.
I-2-10-1 – In subsection A we added a cross reference to new HALLEX section I-1-3-26 regarding "non-redetermination" cases. We also updated the NOTE on appeal rights based on the new SSRs. In subsection B we removed NOTE 3 based on the new SSRs. We made minor editorial changes for readability throughout the section.
I-2-10-6 – In subsection A we removed the NOTE as this information is already present in this subsection and added a cross reference to new HALLEX section I-1-3-26. We revised the first bullet to clarify that any issue that was unfavorably decided in a determination will be at issue in the hearing even if the claimant does not contest the issue. We also revised the sample language used in notices regarding the issues an administrative law judge (ALJ) will consider. In subsection C, we updated the sample language used in notices when reopening is an issue based on fraud or similar fault. We made minor editorial changes for readability throughout the section.
I-2-10-10 – In subsection A we replaced and updated a reference to SSR 16-2p with a reference to SSR 22-2p. We updated subsection A to state that before SSA disregards evidence at the hearings level an adjudicator will consider an individual's objection to the disregarding of the evidence. We updated NOTE 1 in this subsection based on this revised guidance. In subsection D, to the NOTE we added a cross reference to new HALLEX section I-1-3-26. We made minor editorial changes for readability throughout the section.
I-2-10-14 – In subsection A., NOTE 1, we provided additional information regarding the specific instructions that the ALJ will receive when adjudicating claims under HALLEX I-1-3-25 or I-1-3-26. In subsection B.3., we updated guidance on the standard of proof used when adjudicating issues of fraud or similar fault. We added subsection C, to add instructions for considering whether the conditions for reopening due to fraud or similar fault exist. Additionally, we added a NOTE, directing the reader to refer to HALLEX I-2-9-65 for further instructions on reopening a determination for fraud or similar fault. We also replaced and updated references to SSR 16-2p with references to 22-2p throughout the section. We made minor editorial changes for readability throughout the section.
I-2-10-16 – In subsection A.2., we replaced and updated a reference to SSR 16-2p with a reference to SSR 22-2p. We made minor editorial changes for readability throughout the section.
Date: June 7, 2022