TN 10 (03-90)

Process

OARO reviews selected ALJ reversals, (quality assessement sample) revisions and amended decisions. In quality assessment sample cases, ALJ's forward the claims file with their decisions directly to the OARO, Office of Appellate Operations (OAO). The PC is notified of the decisions in RSI cases by a copy of HA-5051-U3 (Transmittal of Decision or Dismissal by an Administrative Law Judge). This form shows the result of the ALJ decision and the subject code.

Reversals, revisions and amended decisions are reviewed immediately and the claims files returned to the PC for prompt action unless the AC takes jurisdiction. In the latter situation, the PC receives a copy of the notice sent to the claimant.

Affirmations and dismissal actions are held with the claims file in the OARO, OAO for association of requests for AC review. After 90 days (120 days if the claimant lives in Puerto Rico), the claims file is returned to the PC when no requests for AC review are received and the AC does not take jurisdiction on its own motion. If the AC takes jurisdiction, the PC receives a copy of the notice sent to the claimant.

NOTE: Do not effectuate cases the AC reviews on its own motion. If a case is erroneously effectuated, do not release any additional underpayment and leave in pay until the AC decision or on remand, the revised ALJ decision.