Before sending any correspondence to the parties, the receiving component must first determine whether the request has been submitted to the proper reviewing official. See Hearings, Appeals, and Litigation Law (HALLEX) manual HA 01120.006C.2. for information on delegated reviewing officials at the hearings and AC levels.

If the receiving component does not have authority to conduct administrative review, that component will refer the request to the proper reviewing official by dating the request and:

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  If there is an associated eView or Electronic Non-Medical (ENM) record, upload the request to the electronic folder, and email notification of the uploaded request to the individual or component delegated the authority to conduct the review. The email will specify if the claim(s) file is in eView or ENM.

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  If there is no associated eView or ENM record, scan the request, and email notification with the attached request to the individual or component delegated the authority to conduct review.

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  The receiving component will use a read receipt or otherwise confirm proper notification.

Once the proper reviewing official receives the request for administrative review, the official or staff will review the request to determine if it was filed timely. If the request was not filed timely, but the requester provided an explanation for the late filing, the reviewing official will consider the explanation and determine if there was good cause for the untimely filing (see HALLEX HA 01120.063B).

When the requester did not provide an explanation for the late filing, the reviewing official will request an explanation using the appropriate notice template in the applicable system and diary the case for 30 days. Once the diary expires, or an explanation is received, the reviewing official will consider the explanation, if any, and determine if there was good cause for the untimely filing (see HALLEX HA 01120.063B).

If the requester does not respond, or there is no basis to find good cause for the late filing based on the explanation, the reviewing official will deny the request for administrative review. The reviewing official will issue a notice of this decision (see HALLEX HA 01120.065).

When the request was timely filed, or the requester establishes good cause for filing late, the reviewing official or staff will send a letter to the party who requested administrative review to:

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  Acknowledge receipt of the request;

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  Inform the requester that SSA will notify any other parties to the initial fee authorization that the request for administrative review has been submitted; and

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  Notify the requester that any other parties will be given the opportunity to comment on the request for administrative review.

The reviewing official will notify any other parties to the initial fee authorization that:

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  The requester filed for administrative review of the amount of the fee; and

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  They have 20 days from date of the notice to comment on or submit written information about the request.

Because of Privacy Act considerations, do not reveal any Privacy Act protected information (personally identifiable information or PII) without applicable disclosure authority (e.g., consent, routine use, etc.), including:

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  The claimant's mailing address, Social Security number (SSN), or beneficiary notice control (BNC) number, which may be included in copies of a letter addressed to the claimant, or the claimant's request for administrative review, sent to a party other than the claimant's representative or the decision maker.

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  The auxiliary beneficiary's mailing address or SSN, which may be included in copies of a letter addressed to the beneficiary, or the beneficiary's request for administrative review, sent to a party other than that beneficiary's representative or the decision maker.

In these situations, the address and any other protected information must be redacted before mailing.

While the administrative review is ongoing, the reviewing official may send interim letters to the parties to:

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  Inform them of additional information received and their right to comment; and

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  Follow up on requested information, when necessary.