In most situations, reference to the Social Security Act (Act), regulations, rulings, the Hearings, Appeals and Litigation Law (HALLEX) manual, or the Program Operations Manual System (POMS) will resolve policy or procedural issues that arise during the adjudication process. On rare occasions, an administrative law judge (ALJ) may observe a novel or unusual situation in which he or she needs further guidance to evaluate an issue(s) fully. On other occasions, hearing office (HO) staff or the Hearing Office Chief Administrative Law Judge (HOCALJ) may bring a novel or unusual situation to the ALJ's attention. An ALJ will generally refer issues for further guidance when:

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  The issue involves a broader impact on the hearing operation (e.g., the issue appears to be new but will likely arise in other situations); or

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  The ALJ is unable to resolve the issue without additional guidance.

To refer a policy or procedural issue(s), an ALJ will first discuss the issue(s) with the HOCALJ. If the HOCALJ agrees further advice is needed, the HOCALJ will forward the matter to the Hearings Hub.

Hearings Hub personnel will evaluate the policy or procedural issue(s) and determine whether referral to Adjudication Practices and Procedures (APP) in Disability Compliance is appropriate. Generally, a referral from the Hearings Hub is appropriate when the policy or procedural question is of such complexity or significance that additional guidance is required, or when it is likely that there is inconsistent application of a policy or procedure nationwide. If referral to APP is appropriate, Hearings Hub personnel will send the referral by email to |||DA DICompliance APP. APP will decide the appropriate course of action based on the particular issue(s) and circumstances.

An ALJ must request a legal opinion from Law and Policy when the Social Security Administration (SSA) specifically instructs the ALJ to obtain such an opinion before adjudicating a case. For example, this scenario can arise when SSA encounters a novel or unusual policy or procedural issue that may impact litigation or is the subject of pending litigation.

In other rare and limited circumstances, an ALJ may find it necessary to request a legal opinion from Law and Policy in order to resolve an adjudication matter. An ALJ may consider requesting an opinion from Law and Policy when:

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  A particular factual situation requires interpretation or clarification of state, federal, or foreign law (e.g., constitutional, privacy, or disclosure issues);

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  The Act, regulations, rulings, HALLEX, POMS, or other agency guidance does not address the issue;

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  The interpretation will affect the outcome of the case and is essential to adjudicate the case; and

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  Law and Policy has not already issued a legal precedent on the issue (see POMS PR-Title II Legal Opinion Precedents and PS-Title XVI Legal Opinion Precedents).

Once the ALJ confirms Law and Policy has not already addressed the issue, the ALJ will consult with the HOCALJ regarding whether obtaining a legal opinion is appropriate. If the HOCALJ agrees, the ALJ will prepare a written recommendation for the Hearings Hub.

After reviewing the written recommendation, the HOCALJ will refer the matter to the Hearings Hub. If the Hearings Hub agrees that requesting a legal opinion is appropriate, the Hearings Hub will refer the matter to Law and Policy at ^LP PFDLaw Controls, with a courtesy copy to APP at |||DA DICompliance APP. Law and Policy will review the request per the instructions in POMS GN 01010.820.

When appropriate, Law and Policy will issue a legal opinion and publish the opinion in POMS. See generally POMS PR – Title II Legal Opinion Precedents and POMS PS – Title XVI Legal Opinion Precedents.