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Office of Disability Adjudication and Review

Volume I

Transmittal No. I-5-6-1

Division 5: I-5-6

Subject: Redeterminations


This transmittal amends section I-5-6-1 of the Hearings, Appeals and Litigation Law manual to update instructions for processing redeterminations of certain cases adjudicated in Puerto Rico.

Explanation of Content and Changes

I-5-6-1 – We changed the title to “Puerto Rico” to clarify that the instructions apply to a broader circumstance than those involving a disqualified non-attorney representative. We updated the information throughout subsections I-IV based on new information and circumstance, including information about several individuals who pleaded guilty to criminal charges. Additionally, we removed references and information regarding individuals who had been indicted but who had not pleaded guilty to the charges. We added information about when an administrative law judge (ALJ) will assist a claimant in developing the record and clarified that a claimant may file a new application while a redetermination claim is pending. We explained that an ALJ or the Appeals Council will issue a decision when redetermining a claim, even when dismissal criteria appear to be present (unless the Appeals Council is taking another grant review action). However, we clarified that if the claim was redetermined at another administrative level and a reason for dismissal was present, an ALJ may dismiss the request for hearing or the Appeals Council may dismiss the request for review. We also provided instructions for handling representative fee issues in redetermination matters.

Date: August 11, 2015