TN 13 (11-11)

A. Policy on requesting legal opinions

This policy is generally for field offices (FOs) but it also applies to processing centers (PCs). Before requesting an initial legal opinion, ensure that you take all possible adjudicative actions for those claimants whose entitlement is not affected by the issue in question. Use the partial award procedures in GN 01010.110 and GN 01010.120. If the claimant meets the criteria in GN 01010.140, and treat the claimant whose entitlement is affected as a delayed claimant.

B. Procedure for requesting legal opinions

Follow the instructions below when you request the legal opinion.

NOTE: Some Regional Offices (ROs) have developed program circulars to supplement these instructions. Check your regional intranet site or contact your RO support staff to determine if there are specific operating procedures to request a legal opinion for offices and employees in your region.

1. Retirement and Survivors Insurance (RSI) initial claim

If a legal opinion is required on a RSI claim or on a non-medical issue in a disability claim, forward the request describing the issue and copies of pertinent material to the appropriate state Assistant Regional Commissioner, Management, Operations and Support (ARC-MOS) or the Center for Program Support (CPS) in the Office of Central Operations (OCO).

2. Post-entitlement actions

Forward the pertinent material with a report of contact describing the issue to the ARC, MOS (see NOTE in GN 01010.815B.1.).

3. Medical issues

If a legal opinion is required for a medical issue on a title II or concurrent title II/title XVI disability claim:

• Develop the disability aspects of the claim not affected by the medical issue;

• Immediately forward the disability portion of the claim to the Disability Determination Services (DDS);

• Without waiting for the DDS reply, send the request with all the pertinent details and copies of any pertinent material to the ARC, MOS for approval and submittal to the Office of Disability (OD) in CO; and

• Store a copy of the request for the legal opinion (with the non-disability material) in the electronic disability folder (eDIB) pending a disability determination from the DDS.

NOTE: Use partial adjudication procedures in GN 01010.110 and GN 01010.120 to pay any title II payments due to beneficiaries not involved in the legal question at issue, if the DDS makes the disability determination before the legal opinion is received.

4. Supplement Security Income (SSI) claims and non-claims situations

If the request for a legal opinion involves an SSI claim or a non-claim issue:

1. Send the request to the ARC, MOS in the region where the resident FO is located; and

2. Maintain a copy of the request.

C. FO Resubmits the Request for Legal Opinion

The FO or PC may resubmit a request for a legal opinion if it believes the legal precedent opinion on SSA Pubs in POMS on Policy Net is no longer applicable due to changes in the state law or modifications by a court decision. In these situations, resubmit the legal issue using the guidelines discussed above.