Upon receipt of a title II ALJ reversal in which nondisability development has been
deferred, ODO will immediately initiate all nondisability development either through
the DO, or directly, as appropriate. The DRS will forward cases to the Reconsideration
Branch for development of nondisability factors.
To expedite effectuation of the ALJ reversal, requirements are modified:
Workers' Compensation development need not be completed prior to effectuation of the
ALJ reversal. If the actual amount of compensation has not been verified, the ALJ
reversal may be effectuated using the claimant's allegation or the State's maximum
Lag earnings affecting only benefit amounts need not be developed prior to effectuation
of the ALJ reversal. This applies only to those cases where lag would affect the benefit
amount but is not needed to establish insured status.
When proof of age is not critical to eligibility (see DI 11010.055), proof of age development need not be completed before effectuation of the ALJ reversal.
NOTE: In all of the above situations, the deferred development must be completed following
effectuation of the ALJ reversal.
Following effectuation of the ALJ reversal, undertake the following, if necessary:
Initiate all previously deferred nondisability development, including auxiliary claims.
Most auxiliary claims (including CDB's and DWB's) should be processed as subsequent
claims. However, if it is possible to effectuate payment to the NH and auxiliaries
simultaneously without delaying payment to the NH, (e.g., the auxiliary development
is complete at the time the NH's claim is ready for effectuation) effectuate all claims
following existing procedures. Also, if the NH has a future month of entitlement at
the time of ALJ reversal (e.g., case is still in the waiting period), ODO or the PSC
may delay effectuation until the auxiliary development is complete so that all the
claims can be effectuated together. This optional procedure should somewhat reduce
the number of subsequent auxiliary claims. However, this procedure should only be
used when it is clear that effectuation of the primary and auxiliary claims will be
done soon enough to assure timely payment to the NH.