Last Update: 8/15/05 (Transmittal I-2-61)
“Claimant,” as used herein, refers to the party to the initial, reconsidered, or revised determination who has requested a hearing before an ALJ, and any other party to the determination, or person whose rights may be adversely affected by a hearing decision. (See I-2-1-45, Parties to the Hearing.)
A claimant filing a request for a hearing under Titles II or XVI of the Social Security Act, as amended, may disagree with only specific aspects of the determination issued at the pre-hearing level. Although not required to do so by statute or regulation, claimants will frequently state the specific aspect(s) of the prior determination with which they disagree, particularly in the space that the Request for Hearing (RH) form (Form HA-501) provides for the claimant to set forth the reason(s) he or she disagrees with the prior determination.
In connection with an RH, an ALJ will consider all the issues which were brought out but not decided entirely in the claimant's favor in an initial, reconsidered, or revised determination. An ALJ will also consider issues previously decided in the claimant's favor if evidence presented before the ALJ issues the hearing decision causes the ALJ to question the favorable determination, or the determination is based on an error of law.
While a prior claim is pending judicial review, the ALJ must limit consideration of subsequent claims to the period, if any, following the period which is the subject of the judicial review. (See I-2-8-16, Administrative Law Judge Decision When a Prior Claim Is Pending Judicial Review.)
B. Consideration of Issue(s) Previously Decided in Claimant's Favor
1. ALJ Receives Addional Evidence Not Considered by the Adjudicator at the Pre-hearing Level, and the Additional Evidence Is Material to the Issues Decided Favorably at the Pre-hearing Level
An ALJ may receive and enter into the record evidence that adjudicators at the initial or reconsideration level did not evaluate. This additional evidence may raise a question about a favorable determination on an issue(s) made at the pre-hearing level. If the ALJ decides that such additional evidence is material to and warrants consideration of an issue(s) decided favorably at the reconsideration level, the ALJ must send advance notice to inform the claimant that the issue(s) will be considered at a hearing. The ALJ will base the decision on the weight of the evidence of record, and make appropriate findings on the issue(s).
2. No Additional Evidence Received That Is Material to Issue(s) Decided Favorably to Claimant at the Pre-hearing Level
If the ALJ does not receive additional evidence that raises a question about a favorable determination made on an issue(s) made in the initial determination, reconsideration, or revised determination, the ALJ will consider the issue(s) only if the determination is based on an error of law. The ALJ must send advance notice to inform the claimant that the issue(s) will be considered at the hearing.