SI 04040.030: Effectuating Appeals Council (AC) Decisions
Effective Dates: 01/12/2017 - Present
- TN 1 (02-02)
- SI 04040.030 Effectuating Appeals Council (AC) Decisions
- A. Policy
- 1. FO Role in Effectuating AC Decisions
- The AC decision or the ALJ's decision if the AC denied the request for review is binding unless the claimant files an action in a U.S. District Court or the decision is revised.
- In SSI cases, the FO is responsible for effectuating AC decisions. For information about AC decisions and notices, see GN 03104.400. See SI 04030.070 for instruction regarding redeterminations after reversals. Effectuate the decision as received.
- 2. FO Protests AC Decision
If the FO believes an AC decision is contrary to the law, regulations, or rulings, it should forward it along with a full explanation of the reasons for disagreement to the regional office for referral to the Deputy Director for Operations, Office of Appellate Operations, ODAR, for further consideration. Otherwise, the FO should effectuate the decision as received. See SI 04030.060A.2.
- 3. RO in Protest Role
Prepare a memorandum to ODAR requesting reopening of the AC decision under the rules of administrative finality in Regulations No. 16, section 416.1487 through 416.1494. Modify the sample memoranda in SI 04030.060C., Exhibits 1-3 for this use by deleting reference to Regulations sections 416.1467 through 416.1470 in the last paragraph. This refers to own motion review by the AC — a procedure applying to ALJ hearing decisions, not to AC decisions. Do not send questionable AC decisions to CO for referral to ODAR. Send them directly to ODAR as in the cases of questionable hearing decisions as described in SI 04030.060.
- Have the FO continue tracking vacated decisions after remand (see SI 04030.060B.). Forward to the FO (or other regional effectuating component) a copy of the AC order of remand to be maintained with the FO control folder until a new decision is rendered.
- 4. Retention of SSI Claims Folders in ODAR After Unfavorable AC Action
The AC retains the claim folder for a period of 150 days after taking an unfavorable action. If the FO needs the claims file to take an immediate action before the 150 days, fax a request for the folder to the ODAR Megasite at (703) 605-8931 or (703) 605-8941. At the end of the 150-day retention period, ODAR will return the SSI folder to the FO.
- B. Reference
- For redeterminations after AC reversal, see SI 04030.070.
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