I-3-1-20.Recommendation to Appeals Council

Last Update: 9/08/05 (Transmittal I-3-36)

A. General

The Appeals Council may deny, dismiss or grant a request for review. The Appeals Council may also review a case on its own motion within 60 days after the date of the hearing decision or dismissal.

If the Appeals Council grants the request for review or reviews a case on its own motion, it may issue a decision, remand the case to an ALJ for further proceedings, or dismiss the request for hearing.

In certain circumstances, the Appeals Council may:

  • reopen or decline to reopen a determination or decision;

  • extend or decline to extend the time for filing a civil action;

  • receive additional evidence into the record;

  • proffer evidence to a claimant or representative;

  • respond to issues raised by a claimant or representative;

  • grant or deny a claimant's request for an appearance; and

  • respond to an ALJ's motion for clarification of a remand order.

When recommending that the Appeals Council take any action, the analyst must prepare the appropriate action document and forms and route them with the case to the designated “A” member AAJ for review and to a “B” member AAJ, if a “B” member AAJ's concurrence is required, or the Appeals Officer, as appropriate.

B. Tone and Content of Analysis and Action Document

In preparing recommendations and action documents, the analyst must use professional and courteous language and refer to deficiencies in a record or decision on the basis of objective criteria. The analyst will not use language that may be emotionally charged, provocative, or offensive. The analyst shall omit personal reactions to any facet of a claimant's life, personality, impairments, behavior, etc., or to the ALJ's conduct.

C. Preparation of Recommendation

  1. The analyst will complete the pertinent parts of either Form HA-52 (Disability Case Fact Sheet) and Form HA-52A (Disability Case Analysis and Recommendation) or the computerized disability fact sheet for each request for review, unappealed review and protest case referred to the Appeals Council.

    • Complete the Form HA-52 or the computerized disability fact sheet to reflect the ALJ's findings.

    • Enter analysis, critiques and recommendations on the Form HA-52A or the computerized disability fact sheet and any necessary continuation sheets.

    • Do not include gratuitous remarks regarding claimants, attorneys, ALJs, hearing office procedures, etc., anywhere in a recommendation to the Appeals Council.

  2. Refer to the appropriate HALLEX section for specific instructions on the following:

Dismissal of Request for Review:

I-3-4

Dismissal of Request for Hearing:

I-3-4-20

Denial of Request for Review:

I-3-5

Grant Request for Review:

I-3-6

Own Motion Review:

I-3-6-50

Remand:

I-3-7

Decision:

I-3-8

Reopening:

I-3-9