Social Security recently made some changes to the way it will look at pre-hearing reviews for those who file a disability claim, the purpose of which, is supposed to free-up more time for Administrative Law Judges (ALJ) to work on the massive backlog of hearings. Another new change, a procedural shift of how ALJs remand cases, has also been put in place, with the hopes that more favorable decisions can be made at the lower levels of the process when the claimant meets all the disability rules.
Remand for Revised Determination
- When to Remand for a Revised Determination
After a claimant files a request for hearing but before an administrative law judge (ALJ) holds a hearing, an ALJ may, under certain circumstances, remand a case to the Disability Determination Services or other component that issued the determination. See 20 CFR 404.948(c) and 416.1448(c). An ALJ may remand for a revised determination on his or her own initiative, or at the request of a claimant.
An ALJ will only remand a case for a revised determination if there is reason to believe the revised determination would be fully favorable to the claimant. While the regulatory language is quite broad, the ALJ will only consider this requirement met if the ALJ is reasonably certain a revised fully favorable determination will be issued on remand. For example, the ALJ may receive new and material evidence that appears to change the outcome, or a change in the law permits a favorable determination.
NOTE:
Despite the regulatory authority to do so, the ALJ will only remand a case for a revised determination if it is more likely than not that the receiving component can more timely adjudicate the case (e.g., the average processing time at the receiving component is significantly shorter than the time the claimant will likely wait for a hearing).
The procedures to remand for a revised determination are separate and distinct from procedures for pre-hearing case review by another agency component. For pre-hearing case review procedures, see Hearings, Appeals and Litigation Law manual I-2-5-10. Of most significance, revised determination remands differ from pre-hearing case reviews because:
A remand results in an immediate dismissal of the request for hearing; and
If a claimant disagrees with the revised determination after a remand, he or she must submit a new request for hearing.
- Procedures
To remand a case for a revised determination, the ALJ will prepare a Notice Vacating Reconsideration Determination and Remanding To the Social Security Field Office. In the remand order, the ALJ will explain the reason for the remand. If the ALJ remands the case on his or her own initiative (and not at the request of the claimant), the ALJ must also notify the claimant that if he or she objects to a remand, he or she must notify the ALJ of his or her objections within 10 days of the date the case is remanded. Otherwise, the ALJ will assume the claimant agrees to the remand.
NOTE:
If the claimant submits an objection to the remand, the ALJ will consider the objection and rule on it in writing. If the ALJ finds that the case should not have been remanded based on the objection, the ALJ or hearing office staff will contact the field office to request jurisdiction of the case. On return of the case, hearing office staff will place the case in the Master Docket based on the filing date of the request for hearing.
The ALJ will send the notice to the claimant at his or her last known address. At the time the order is released, hearing office staff will dismiss the case in the Case Processing and Management System using the code Dismissal-Administrative (ADDI). It is essential that hearing office staff use the ADDI code to alert the field office that additional action is required on the claim and to ensure jurisdiction is transferred to the field office.
