II-5-1-7.Appeals Council Action When an Administrative Law Judge (ALJ) Should Have Dismissed on the Basis of Administrative Res Judicata

Appeals Council Interpretation

SUBJECT : Appeals Council Action When an Administrative Law Judge (ALJ) Should Have Dismissed on the Basis of Administrative Res Judicata
     
ISSUE : Will the Appeals Council assume jurisdiction to dismiss a request for hearing when an ALJ has issued a decision on the merits but should have dismissed the request for hearing on the basis of administrative res judicata?
     
DISCUSSION : The regulations at 20 CFR §§ 404.957(c)(1) and 416.1457(c)(1) provide that an ALJ may dismiss a request for hearing entirely or refuse to consider any one or more of the issues if the doctrine of res judicata applies. The conditions for the application of administrative res judicata are present when there has been a previous determination or decision under the same title of the Act about the same party's rights on the same facts and on the same issue or issues, and this previous determination or decision has become final by either judicial or administrative action.
     
    The ALJ should consider whether to apply administrative res judicata in all appropriate instances. Although an ALJ has discretion to determine whether the prior and current claims involve the same parties, facts and issues, application of administrative res judicata is mandatory when the requisite conditions are met.
     
    Accordingly, the Appeals Council has decided that it will continue to assume jurisdiction in order to dismiss a request for hearing in whole or in part on the basis of administrative res judicata when the ALJ has issued a decision on the merits but should have wholly or partially dismissed the request on the basis of administrative res judicata.
     
INTERPRETATION : The Appeals Council will ordinarily assume jurisdiction on error of law grounds when the ALJ issued a decision on the merits but the record shows that the request for hearing should have been dismissed in whole or in part on the basis of administrative res judicata. The Appeals Council will vacate the hearing decision as appropriate and dismiss the request for hearing in whole or in part. If the Appeals Council concludes that further proceedings are necessary to consider whether administrative res judicata applies, it will remand the case.
     
APPLICATION : The Appeals Council will apply this interpretation in all cases that come before it involving the same issue.
     
EFFECTIVE DATE : August 27, 1991
     
CROSS-REFERENCE : 20 CFR §§ 404.957(c)(1) and 416.1457(c)(1); HALLEX I-2-4-40 and I-3-3-9.