Identification Number:
SI 04040 TN 4
Intended Audience:See Transmittal Sheet
Originating Office:ORDP OISP
Title:Appeals Council (AC) Review - SSI
Type:POMS Transmittals
Program:All Programs
Link To Reference:
 

PROGRAM OPERATIONS MANUAL SYSTEM
Part SI – Supplemental Security Income
Chapter 040 – Administrative Review, Appeals and Finality - SSI
Subchapter 40 – Appeals Council (AC) Review - SSI
Transmittal No. 4, 12/04/2018

Audience

OCO-OEIO: FDE, RECONE;
FO/TSC: CS, CS TXVI, CSR, CTE, DRT, FR, OA, OS, RR, TA, TSC-CSR;

Originating Component

OISP

Effective Date

Upon Receipt

Background

 

This is a Quick Action Transmittal. These Revisions do not change or introduce new policy or procedure.

Summary of Changes

SI 04040.030 Effectuating Appeals Council (AC) Decisions

A.2 added (OAO) after Office of Appellate Operations

A.3 Deleted (OAO) after the Office of Appellate Operations

A.4 Heading - Deleted and replaced ODAR with OAO

 

SI 04040.030 Effectuating Appeals Council (AC) Decisions

A. Policy

1. FO Role in Effectuating AC Decisions

The AC decision or the ALJ's decision if the AC denied the request for review is binding unless the claimant files an action in a U.S. District Court or the decision is revised.

In SSI cases, the FO is responsible for effectuating AC decisions. For information about AC decisions and notices, see GN 03104.400. See SI 04030.070 for instruction regarding redeterminations after reversals. Effectuate the decision as received.

2. FO Protests AC Decision

If the FO believes an AC decision is contrary to the law, regulations, or rulings, it should forward it along with a full explanation of the reasons for disagreement to the regional office for referral to the Deputy Director for Operations, Office of Appellate Operations (OAO), Office of Analytics, Review, and Oversight (OARO), for further consideration. Otherwise, the FO should effectuate the decision as received. See SI 04030.060A.2.

3. RO in Protest Role

Prepare a memorandum to OARO, OAO requesting reopening of the AC decision under the rules of administrative finality in Regulations No. 16, section 416.1487 through 416.1494. Modify the sample memoranda in SI 04030.060C., Exhibits 1-3 for this use by deleting reference to Regulations sections 416.1467 through 416.1470 in the last paragraph. This refers to own motion review by the AC — a procedure applying to ALJ hearing decisions, not to AC decisions.

Do not send questionable AC decisions to CO for referral to OARO, OAO. Send them directly to OARO, OAO as in the cases of questionable hearing decisions as described in SI 04030.060.

Have the FO continue tracking vacated decisions after remand (see SI 04030.060B.). Forward to the FO (or other regional effectuating component) a copy of the AC order of remand to be maintained with the FO control folder until a new decision is rendered.

4. Retention of SSI Claims Folders in OAO After Unfavorable AC Action

The AC sends the claim folder to the Social Security National Records Center (SSANRC). If the FO needs the claims file, contact the SSANRC.

B. Reference

For redeterminations after AC reversal, see SI 04030.070.

 


SI 04040 TN 4 - Appeals Council (AC) Review - SSI - 12/04/2018