Last Update: 5/13/2014 (Transmittal I-3-65)
HA 01395.009 Appeals Council
(AC) Referrals to the Office of the Inspector General
Renumbered from HALLEX section I-3-10-9
When the AC suspects fraud or a criminal violation by a representative,
employee, contractor, claimant, or other member of the public, and
the issue is not before the AC on review, the AC will use the applicable
instructions in Hearings, Appeals and Litigation Law (HALLEX) manual HA 01130.000.
However, if an issue of fraud or similar fault is first raised
or identified during AC review in a disability case, the AC may
use the referral instructions in HALLEX HA 01130.021. The AC will then use
the applicable instructions in HALLEX HA 01395.000 to process the issue.
Though the Cooperative Disability
Investigation Units (CDIU) generally investigate only disability
issues, if an issue of fraud or similar fault arises during case adjudication
in a non-disability case, the AC may use the same general referral procedures
in HALLEX HA 01130.021.
If necessary, the CDIU will transfer the issue to the Office of
the Inspector General.