Articles from prior issues of The Advocate

January/February, 1996

Comments on the Appeals Council Task Team Report
by Susan Neitzert and Pinkney Newell, as directed by the NADE Board, report dated May 11, 1995

THESE ARE OUR COMMENTS ON recommendations from the Appeals Council Task Team Report.

Modified Appellate Role for the Appeals Council

This is a transitional role to prevent unduly burdening the Federal Courts. This streamlining and limitations of the Appeals Council should enable the Council to expand its own motion activities consistent with the ultimate redesign vision. There are two major elements to this proposal which are commented on below:

1. We support the closing of the administrative record as of the date of the hearing decision, allowing submission of new evidence to the Administrative Law Judge for consideration of whether the evidence is new and material, and whether there is good cause for failure to submit earlier.

2. We agree that the claimant should have to state specific disagreements to the hearing decision at the time the claimant files a request for review in order to focus the issues before the appeals Council.

Appeals Council Task Team Sub Proposal For The Immediate Increase In Review of Favorable Hearing Level Decisions by the Appeals Council

This proposal is to work towards an equal review of cases allowed and denied at the ALJ level, the identification of error-prone cases, and case issues that require policy clarification. Comments follow below: We support the random review of an equal number of allowances and denials in order to determine specific case characteristics that are error-prone. In addition, we support focused review of case characteristics that are found to be error-prone to improve decision quality and to track areas of troublesome issues that are developing. This information would be shared with other SSA components so that needed policy clarification could be done.

Target Operational Role for the Appeals Council

The Task Teams new model for the Appeals Council envisions four different roles. Comments on each role are as follows:

1. We support In-Process Review of the Hearing Process of ALJ and AO decisions and dismissals at the AC’s own motion. However, we do question whether in their new roles they would have the time to also adjudicate “Protest Cases” from DCMs regarding technical issues that prevent effectuation of payment.

2. We support the goals of End-Of-Process Review to assure quality decisions at all levels of the program.

3. We support the Appeals Council’s continuing role in Litigation Management.

4. We support the AC’s role in providing Policy Input.

5. We support the continuing AC’s role in reviewing Bias/Unfair Hearing/Misconduct Allegations.