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SOCIAL SECURITY ADMINISTRATION
Office of Analytics, Review, and Oversight

HALLEX
Volume I

Transmittal No. I-5-600

Division 5: I-5-6

Subject: Redeterminations under Sections 205(u) and 1631(e)(7) of the Social Security Act

Background

This transmittal amends certain sections in I-5-6 of the Hearings, Appeals and Litigation Law (HALLEX) manual to clarify the applicable law in fraud redetermination cases.

Explanation of Content and Changes

HALLEX I-5-6-1 – We added new subsections III.A.7., III.B.3., and IV.A.5. to clarify that the adjudicator must use the listings in the Listing of Impairments (20 CFR, Part 404, Subpart P, Appendix 1) that were in effect at the time of the original favorable determination or decision. In these new subsections, we explained that the national uniformity regulations apply regardless of when the original favorable determination or decision was issued. We also added notes in III.A.1. and IV.A.1. to clarify that when adjudicators are determining whether the initial assessment is supported by a preponderance of the evidence in the record, they will apply the listings that were in effect at the time of the original favorable decision. We edited III.A.4.c. III.B.4.c to comply with the national uniformity regulations. We removed references to Social Security Rulings 96-3p and 96- 4p in light of their rescission, effective June 14, 2018. We changed references to the Office of Disability Adjudication and Review to the Office of Hearings Operations and clarified that the Office of Appellate Operations was moved to the Office of Analytics, Review, and Oversight. We added the case characteristics to the section title and also made minor editorial changes.

HALLEX I-5-6-2 – We added new subsections IV.D. and V.F. to clarify that the adjudicator must use the listings in the Listing of Impairments (20 CFR, Part 404, Subpart P, Appendix 1) that were in effect at the time of the original favorable determination or decision. In these new subsections, we explained that the national uniformity regulations apply regardless of when the original favorable determination or decision was issued. We edited V.C.3. to comply with the national uniformity regulations. We removed references to Social Security Rulings 96-3p and 96-4p in light of their rescission, effective June 14, 2018. We changed references to the Office of Disability Adjudication and Review to the Office of Hearings Operations and clarified that the Office of Appellate Operations was moved to the Office of Analytics, Review, and Oversight. We added the case characteristic to the section title and also made minor editorial changes.

HALLEX I-5-6-3 – We added new subsections III.A.7. and III.B.3. to clarify that the adjudicator must use the listings in the Listing of Impairments (20 CFR, Part 404, Subpart P, Appendix 1) that were in effect at the time of the original favorable determination or decision. In these new subsections, we explained that the national uniformity regulations apply regardless of when the original favorable determination or decision was issued. We also added a note in III.A.1. to clarify that when adjudicators are determining whether the initial assessment is supported by a preponderance of the evidence in the record, they will apply the listings that were in effect at the time of the original favorable decision. We removed references to Social Security Rulings 96-3p and 96-4p in light of their rescission, effective June 14, 2018. We added the case characteristic to the section title and also made minor editorial changes.

HALLEX I-5-6-5 – We added new subsections III.A.7., III.B.3., and IV.A.5. to clarify that the adjudicator must use the listings in the Listing of Impairments (20 CFR, Part 404, Subpart P, Appendix 1) that were in effect at the time of the original favorable determination or decision. In these new subsections, we explained that the national uniformity regulations apply regardless of when the original favorable determination or decision was issued. We also added a note in III.A.1. to clarify that when adjudicators are determining whether the initial assessment is supported by a preponderance of the evidence in the record, they will apply the listings that were in effect at the time of the original favorable decision. We edited III.A.4.b. and III.B.4.b. to comply with the national uniformity regulations. We removed references to Social Security Rulings 96-3p and 96-4p in light of their rescission, effective June 14, 2018. We changed references to the Office of Disability Adjudication and Review to the Office of Hearings Operations and clarified that the Office of Appellate Operations was moved to the Office of Analytics, Review, and Oversight. We added the case characteristic to the section title and also made minor editorial changes.

HALLEX I-5-6-6 – We added new subsections III.G. and IV.A.3. to clarify that the adjudicator must use the listings in the Listing of Impairments (20 CFR, Part 404, Subpart P, Appendix 1) that were in effect at the time of the original favorable determination or decision. In these new subsections, we explained that the national uniformity regulations apply regardless of when the original favorable determination or decision was issued. We also added a note in III.A. to clarify that when adjudicators are determining whether the initial assessment is supported by a preponderance of the evidence in the record, they will apply the listings that were in effect at the time of the original favorable decision. We edited III.D.2. to comply with the national uniformity regulations. We removed references to Social Security Rulings 96-3p and 96-4p in light of their rescission, effective June 14, 2018. We changed references to the Office of Disability Adjudication and Review to the Office of Hearings Operations and clarified that the Office of Appellate Operations was moved to the Office of Analytics, Review, and Oversight. We added the case characteristic to the section title and also made minor editorial changes.

HALLEX I-5-6-7 – We added new subsections III.A.7., III.B.3., and IV.A.5. to clarify that the adjudicator must use the listings in the Listing of Impairments (20 CFR, Part 404, Subpart P, Appendix 1) that were in effect at the time of the original favorable determination or decision. In these new subsections, we explained that the national uniformity regulations apply regardless of when the original favorable determination or decision was issued. We also added notes in III.A.1. and IV.A.1. to clarify that when adjudicators are determining whether the initial assessment is supported by a preponderance of the evidence in the record, they will apply the listings that were in effect at the time of the original favorable decision. We edited III.A.4.b. and III.B.4.b. to comply with the national uniformity regulations. We removed references to Social Security Rulings 96-3p and 96-4p in light of their rescission, effective June 14, 2018. We added the case characteristic to the section title and also made minor editorial changes.

HALLEX I-5-6-8 – We added new subsections III.A.6., III.B.3., and IV.A.5. to clarify that the adjudicator must use the listings in the Listing of Impairments (20 CFR, Part 404, Subpart P, Appendix 1) that were in effect at the time of the original favorable determination or decision. In these new subsections, we explained that the national uniformity regulations apply regardless of when the original favorable determination or decision was issued. We also added notes in III.A.1. and IV.A.1. to clarify that when adjudicators are determining whether the initial assessment is supported by a preponderance of the evidence in the record, they will apply the listings that were in effect at the time of the original favorable decision. We edited III.A.3.b. and III.B.4.b. to comply with the national uniformity regulations. We removed references to Social Security Rulings 96-3p and 96-4p in light of their rescission, effective June 14, 2018. We added the case characteristic to the section title and also made minor editorial changes.

HALLEX I-5-6-10 – We added new subsections IV.E. and V.A.6. to clarify that the adjudicator must use the listings in the Listing of Impairments (20 CFR, Part 404, Subpart P, Appendix 1) that were in effect at the time of the original favorable determination or decision. In these new subsections, we explained that the national uniformity regulations apply regardless of when the original favorable determination or decision was issued. We also added a note in V.A.1. to clarify that when adjudicators are determining whether the initial assessment is supported by a preponderance of the evidence in the record, they will apply the listings that were in effect at the time of the original favorable decision. We edited IV.A.B.2. to comply with national uniformity regulations. We removed references to Social Security Rulings 96-3p and 96-4p in light of their rescission, effective June 14, 2018. We also made minor editorial changes.

HALLEX I-5-6-11 – We added new subsections IV.E. and V.A.6. to clarify that the adjudicator must use the listings in the Listing of Impairments (20 CFR, Part 404, Subpart P, Appendix 1) that were in effect at the time of the original favorable determination or decision. In these new subsections, we explained that the national uniformity regulations apply regardless of when the original favorable determination or decision was issued. We also added a note in V.A.1. to clarify that when adjudicators are determining whether the initial assessment is supported by a preponderance of the evidence in the record, they will apply the listings that were in effect at the time of the original favorable decision. We edited IV.A.B.2. to comply with national uniformity regulations. We removed references to Social Security Rulings 96-3p and 96-4p in light of their rescission, effective June 14, 2018. We also made minor editorial changes.

HALLEX I-5-6-12 – We added new subsections IV.E. and V.D. to clarify that the adjudicator must use the listings in the Listing of Impairments (20 CFR, Part 404, Subpart P, Appendix 1) that were in effect at the time of the original favorable determination or decision. In these new subsections, we explained that the national uniformity regulations apply regardless of when the original favorable determination or decision was issued. We also added a note in V.A.1. to clarify that when adjudicators are determining whether the initial assessment is supported by a preponderance of the evidence in the record, they will apply the listings that were in effect at the time of the original favorable decision. We edited IV.A.B.2. to comply with national uniformity regulations. We removed references to Social Security Rulings 96-3p and 96-4p in light of their rescission, effective June 14, 2018. We also made minor editorial changes.

HALLEX I-5-6-13 – We added new subsections III.A.6. and III.B.3. to clarify that the adjudicator must use the listings in the Listing of Impairments (20 CFR, Part 404, Subpart P, Appendix 1) that were in effect at the time of the original favorable determination or decision. In these new subsections, we explained that the national uniformity regulations apply regardless of when the original favorable determination or decision was issued. We also added a note in III.A.1. to clarify that when adjudicators are determining whether the initial assessment is supported by a preponderance of the evidence in the record, they will apply the listings that were in effect at the time of the original favorable decision. We edited III.A.3.b. and III.B.4.b. to comply with national uniformity regulations. We removed references to Social Security Rulings 96-3p and 96-4p in light of their rescission, effective June 14, 2018. We added the case characteristic to the section title and also made minor editorial changes.

HALLEX I-5-6-14 – We added new subsections III.A.6. and III.B.3. to clarify that the adjudicator must use the listings in the Listing of Impairments (20 CFR, Part 404, Subpart P, Appendix 1) that were in effect at the time of the original favorable determination or decision. In these new subsections, we explained that the national uniformity regulations apply regardless of when the original favorable determination or decision was issued. We also added a note in III.A.1. to clarify that when adjudicators are determining whether the initial assessment is supported by a preponderance of the evidence in the record, they will apply the listings that were in effect at the time of the original favorable decision. We edited III.A.3.b. and III.B.4.b. to comply with national uniformity regulations. We removed references to Social Security Rulings 96-3p and 96-4p in light of their rescission, effective June 14, 2018. We also made minor editorial changes.

Date: April 5, 2019