POMS Reference

This change was made on Dec 18, 2017. See latest version.
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DI 33020.030: Informal Remand of Administrative Law Judge (ALJ) Hearing Case

changes
*
  • Effective Dates: 02/22/2013 - Present
  • Effective Dates: 12/18/2017 - Present
  • TN 4 (02-90)
  • TN 5 (12-17)
  • DI 33020.030 Informal Remand of ALJ Hearing Case
  • DI 33020.030 Informal Remand of Administrative Law Judge (ALJ) Hearing Case
  • A. Policy
  • A. Policy for informal remands
  • See DI 27520.005
  • See instructions, Disability Determination Services (DDS) action upon receipt of informal remand (IR) cases in DI 27520.005.
  • B. Procedure
  • B. Procedure for referring a case to the disability hearing unit (DHU)
  • 1. When case received
  • 1. When the disability hearing unit (DHU) receives a case
  • When an informal remand case is received in the DHU, refer it to a DHO who had no prior involvement in the case.
  • When the disability-hearing unit (DHU) receives an informal remand case from an ALJ, refer it to a disability-hearing officer (DHO) who had no prior involvement in the case.
  • 2. DHO actions
  • * General
  • Review the case and decide if the reconsidered determination which is under appeal can be revised based on the evidence available in the claims folder.
  • * Review shows fully favorable determination warranted
  • * Prepare an SSA-831-U3, SSA-832-U3 or SSA-833-U3, as appropriate, to revise the reconsidered determination. Annotate the remarks section of these forms “Informal Remand Case.”
  • * Refer to 3.a. and b. below for notices.
  • * Notify the ALJ office of the revised determination by providing it with two copies of the DHO's favorable determination. (This is necessary in order for the ALJ to dismiss the hearing request.)
  • * Follow normal routing instructions and annotate the SSA-2640 to identify the case as an informal remand.
  • * Review shows partially favorable determination warranted
  • * Do not issue a determination if the case was remanded from an ALJ office, either directly to the DHU or by way of the DDS. Return the case to the ALJ office as shown in d. below. (See DI 29005.030B.2 for DDS instructions in this area.)
  • * Issue the partially favorable determination if the case was remanded from the FO. Follow b. above for revising the reconsidered determination.
  • * Review shows prior determination cannot be changed
  • * Send the claims folder to the ALJ office within seven calendar daysof the DHU's receipt.
  • * Forward the folder via an SSA-408 annotated “DHU Action Could Not Be Taken As A Result Of The Pre-hearing Review.”
  • 3. Notices
  • * Title II cases
  • Do not send any notice when a fully or partially favorable determination is made.
  • * Title XVI cases
  • * See DI 27520.005 for model language and note that the language may need to be revised to fit the particular case.
  • * Prepare the notice on an SSA-L8165-U2 (Supplemental Security Income Notice of Decision).
  • * Retain a copy of the notice in the DHU and claims folders.
  • a. General procedures to revise a decision
  • The DHO will review the case and decide if, based on the evidence available in the case folder, we can revise the decision. Prepare a revised decision only when the DHO can make a fully favorable decision.
  • b. Review shows fully favorable decision warranted
  • * Prepare an SSA-831, SSA-832, or SSA-833, as appropriate, to revise the reconsidered decision. Annotate in the Remarks section of these forms “Informal Remand Case”.
  • * Refer to 3.a. and b. in this subsection for notices.
  • * Notify the ALJ’s office of the revised decision by providing it with two copies of the DHO's favorable decision. (This action is necessary for the ALJ to dismiss the hearing request.)
  • * Follow normal routing instructions and annotate the SSA-2640 to identify the case as an informal remand.
  • * For Title II cases do not send a notice.
  • * For Title XVI cases, including Title XVI portion of a concurrent case, see notice instructions and model language DI 27520.005. When appropriate, revise wording for a specific case. Prepare the notice on an SSA-L8165, Supplemental Security Income Notice of Decision. Retain a copy of the notice in the DHU case folder.
  • c. Review shows partially favorable decision warranted
  • * Do not issue a decision if an ALJ’s office remanded the case, either directly to the DHU or by way of the DDS.
  • * Return the case to the ALJ’s office as shown in this subsection d. See disability decision services (DDS) instructions DI 29005.030B.2.
  • * If the FO remanded the case, issue the partially favorable decision for revising the reconsidered decision, follow DI 33020.030B.2.b. in this subsection.
  • d. Review shows prior decision cannot be changed
  • * Send the case folder to the ALJ’s office within seven calendar days of the DHU's receipt.
  • * Forward the folder via an SSA-408 annotated “DHU action could not be taken as a result of the pre-hearing review.”