POMS Reference

DI 23020: Priority Cases

TN 2 (01-08)

A. AC Process

A claimant who is dissatisfied with an ALJ's decision may request a review of the decision by the AC. The AC may deny a request for review if it would result in no advantage to the claimant, or it may grant review and affirm, modify, or reverse the ALJ's decision. Occasionally the AC remands the case to the ALJ for additional development and consideration and for preparation of an amended hearing decision. Even though a claimant may not request AC review, the AC may institute a review of the ALJ's decision on its own motion or the recommendation of the Program Service Center-Disability Review Section (PSC-DRS). The AC usually sees only the hearing record developed by the ALJ, i.e., affidavits, documentary evidence, and testimony obtained by the ALJ, and the SSA disability file. The AC may invite the claimant or the claimant’s authorized representative to submit additional evidence, and the claimant or claimant’s representative may appear before the Council. Also, the AC may ask various sources for additional information before reaching a decision.

B. Disability Determination Services (DDS) Role

Where the AC requests the DDS directly to undertake additional development, process such requests in accordance with “Assistance Request from the Office of Hearings Operations (OHO)” (DI 29501.000). The DDS should use the telephone, fax, or other electronic means to expedite such action. Notify the AC of unexpected case delays or problems via Form SSA-5002, Report of Contact (RC) for EDCS cases, or by telephone for non-EDCS cases.