Last Update: 7/27/2015 (Transmittal I-2-145)
HA 01290.006 Administrative Law Judge Believes Claimant Is Disabled During
Time Adjudicated in Appeals Council Decision
Renumbered from HALLEX section I-2-9-6
When, during a current case adjudication, an administrative
law judge (ALJ) believes new evidence establishes the claimant was
disabled during a time period adjudicated in a prior Appeals Council
(AC) decision, the ALJ's action in the current claim will depend on
whether the time period for reopening the prior decision has expired. For
information about computing the time period for reopening, see Hearings,
Appeals and Litigation Law (HALLEX) manual .
If the time period for reopening has expired, the ALJ will include
the following information in the decision:
•
The claimant is disabled as of the date established
by the evidence, but is only entitled to benefits based on the current
application; and
•
If the claimant explicitly requested reopening (see
HALLEX HA 01290.010 A),
an explanation of why reopening is not possible.
If the claimant implied a
request for reopening (see HALLEX HA 01290.010 B), the ALJ may but is not required
to specifically address the reopening issue in the decision.
If the time period for reopening has not expired, the ALJ
will:
•
Issue a decision finding the claimant disabled as of
the day after the date of the AC decision, and find entitlement based
on the current application only;
•
State in the decision that the AC decision on the prior
application is final and binding;
•
Inform the effectuating component that the AC has
jurisdiction to consider reopening its decision on the prior application,
and if there is a paper claim(s) file, ask the effectuating component
to forward the claim(s) file to the AC after completing its action;
and
•
Send a memorandum (and a copy of the decision if the
claim(s) file is paper) to the Office of the Chief Administrative Law
Judge (OCALJ) at ||| DCDA OHO HQ OCALJ DFP explaining the situation
and requesting that OCALJ immediately forward the matter to the AC to
consider reopening its decision.