Last Update: 5/1/2017 (Transmittal I-3-154)

HA 01330.001 Bases for Appeals Council Grant Review Action

Renumbered from HALLEX section I-3-3-1

Pursuant to 20 CFR 404.970(a) and 416.1470(a), the Appeals Council (AC) will grant review of a case if:

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  There appears to be an abuse of discretion by the administrative law judge (ALJ) (see Hearings, Appeals and Litigation Law (HALLEX) manual HA 01330.002);

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  There is an error of law (see HALLEX HA 01330.003);

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  The ALJ's action, findings, or conclusions are not supported by substantial evidence (see HALLEX HA 01330.004); or

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  There is a broad policy or procedural issue that may affect the general public interest.

Additionally, the AC will evaluate additional evidence if the claimant meets one of the good cause exceptions set forth in 20 CFR 404.970(b) and 416.1470(b). For instructions about how to determine whether there is good cause, see HALLEX HA 01330.006.

The AC will grant review of the case if the additional evidence is new, material, related to the period on or before the date of the hearing decision, and if there is a reasonable probability that the additional evidence will change the outcome of the decision. The AC will evaluate the additional evidence with the entire record. See 20 CFR 404.970(a)(5) and 416.1470(a)(5).

When the AC grants review, the AC will take one of the following actions:

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  Issue a fully favorable, partially favorable, or unfavorable decision (HALLEX HA 01380.000);

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  Remand the case to an ALJ (HALLEX HA 01370.000); or

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  Dismiss the claimant's request for hearing for any reason for which the ALJ could have dismissed the request for hearing (HALLEX HA 01340.020).