For all interim period cases received by OAO, the AC will use the
guidance in subsection VII, Questions and Answers, when readjudicating
the claim.
If the FO sends an interim period case to OAO for readjudication,
designated OAO staff will ensure that it meets the technical criteria
for readjudication. If the readjudication request does not satisfy the
technical criteria, OAO will document the reason why the case does
not satisfy the technical criteria on a ROC, close the ARPS record
as a Special Dismissal (SPDI), and return the case to the FO by email
(POMS DI 52707.015
B.2).
If there is a paper claim file, OAO will respond to the FO with
instructions for routing of the paper file, if necessary.
To determine whether application of the
Earley AR would change the final decision of the
interim period case, the AC must consider the findings contained in the
final decision of the earlier claim as evidence in light of all relevant
facts and circumstances. In determining the probative value of such a
prior finding, the AC will consider the factors described in subsection
VII, Q&A 3.
The AC will only develop the record and issue a decision for
the period at issue in the interim claim. If the claimant filed a new
disability application after the interim claim that resulted in an
allowance, the AC will not disturb the subsequent allowance.
a. Fully Favorable Decision Supported
If application of the Earley AR results in
a fully favorable readjudication decision, the AC will issue a favorable
readjudication decision.
b. Fully Favorable Decision Not Supported
If the application of the Earley AR,
(1)
does not change the outcome,
(2)
does not result in an outcome more favorable to the claimant,
or
(3)
results in a more favorable outcome that is not fully
favorable,
the AC will issue a separate notice explaining its proposed
findings regarding the readjudication. The notice will provide the
claimant and any representative 30 days to comment on the proposed
action and/or request a hearing on the issue of whether application
of the Earley AR changes the outcome of
the prior decision.
(i)
No Request for Hearing and Comments Do Not
Support a Change in Action
If neither the claimant, nor any representative, requests a
hearing within 30 days of the AC notice, and any comments submitted do
not warrant a change in the AC's proposed action, the AC will issue a
readjudication decision.
If the prior decision remains unchanged or does not result in an
outcome more favorable to the claimant, the AC will issue a No Change in
Outcome readjudication decision that will find that the earlier decision
remains the final decision of the agency. The notice will include
appeal rights to federal court on the issue of whether application of
the Earley AR would result in a more favorable
outcome to the claimant.
If application of the Earley AR results in a
readjudication decision that is partially favorable to the claimant, the
AC will issue a new partially favorable readjudication decision.
(ii)
Request for Hearing Submitted or Other
Grounds Support Remand
If the claimant or any representative requests a hearing in response
to the AC's notice, the AC must remand the case to OHO for any issue on
which the AC is not making a favorable finding.
The AC may also remand if the record is insufficient to make a
decision on the readjudication request.
The AC remand will not vacate the prior final AC decision and will
specifically note that:
•
The prior decision on the claimant's interim period claim
satisfies the technical criteria for readjudication under the
Earley AR.
•
The ALJ will conduct supplemental proceedings consistent
with the Earley AR, including holding a
hearing.
•
The ALJ will determine if the application of the
Earley AR would change the outcome of the decision
to be more favorable to the claimant.
•
The ALJ will issue a recommended decision.
The AC will use its normal procedures to issue the remand order
and route the case to OHO office code ELL (NSD Falls Church).
OHO will notify OAO that a recommended decision has been issued
by emailing ^DCARO OAO.
OAO will process the recommended decision consistent with HALLEX
HA 01320.050 C; except,
the AC will only adjudicate the period through the date of the interim
decision.