II-6-1-43. SAMPLE HA-505 Transmitting Additional Evidence to Another Component to Consider Reopening AC Denied R/R of ALJ Dismissal (Use With DEN 20)

TRANSMITTAL BY OFFICE OF HEARINGS AND APPEALS

DATE:

TO:
[Insert Name and Address of Component]

FROM:
APPEALS COUNCIL

BY:

(Claimant's Name and SSN)

[Insert Claimant's Name and SSN]

(Wage Earner) (Leave blank if same as above)

ATTACHMENT(S):
____ Claim File(s)
____ Appeals Council Notice
____ Other

The Appeals Council has denied the claimant's request for review of the Administrative Law Judge's dismissal.

The claimant submitted additional evidence which is not relevant to the issue(s) before the Appeals Council. We are referring it to you to consider whether it warrants reopening and revision of your prior action.

Please take appropriate action and notify the claimant and the representative, if any.