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  • HALLEX - Severe.net
    he or she must prepare a brief Memorandum for File see I 4 299 Exhibit E to the Court Records CR technician The memorandum must note that the analyst reviewed the inaudible portions and determined they did not preclude defensibility of the case and that the CR technician must prepare the certified administrative record CAR B Missing Files or Exhibits If the analyst cannot locate the claim file see I 4 112 D he or she must note on the HA 552 that remand is being requested to locate or re construct the record Occasionally the CR technician may return a new court case to an analyst noting that one or more exhibits are missing from the record The analyst must request these missing documents from the Administrative Law Judge ALJ and or the claimant s attorney If the analyst cannot locate the documents he or she must review the decision and the record to determine whether the missing exhibits preclude defensibility of the case If the analyst determines that the case cannot be defended he or she must complete a HA 552 noting the missing documents and requesting remand If the analyst concludes that the missing exhibits do not preclude defense of case he or she must complete a Memorandum for File see I 4 299 Exhibit E to this effect When the Director OCA certifies the record the certification must identify the missing exhibits C Additional Evidence A court records technician may discover additional evidence which the claimant has submitted to the Appeals Council but which the Council has not yet considered see I 4 152 D The analyst will review the record in these cases in light of the additional evidence to determine whether remand appears warranted If the analyst believes remand is not warranted he or

    Original URL path: http://www.severe.net/hallex4-125.html (2016-05-01)
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  • HALLEX - Severe.net
    U S Attorney uses the affidavit as a supporting document accompanying a motion filed with the court The affidavit must not contain any legal argument evaluation of the evidence or case law citation An operating Division Director or an analyst designated as Acting Director will sign the affidavit The division clerks will prepare routine untimely filed affidavits and submit them to analysts for review Analysts prepare all other affidavits The

    Original URL path: http://www.severe.net/hallex4-130.html (2016-05-01)
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  • HALLEX - Severe.net
    I 4 142 that final decision is either an Appeals Council decision or an Appeals Council denial of a request for review We presume that the claimant receives the Appeals Council notice 5 days after the date of the notice unless there is a reasonable showing to the contrary To determine whether a complaint is timely begin by adding 5 calendar days to the date of the Appeals Council s notice If this is a Sunday or federal holiday assume that receipt occurred on the next U S Postal Service business day Add 60 calendar days to the presumed receipt date This is the civil action filing deadline date Should this date fall on a Saturday Sunday or a federal holiday the deadline is the next federal business day It is important to remember that both the U S Postal Service and the federal district courts are closed on federal holidays Any complaint filed beyond the deadline date is untimely unless the Appeals Council has granted an extension of time The OCA clerk must request the Division Director to assign any cases involving a request for an extension of time which the Appeals Council has not yet considered to an analyst B Determining the Date of Filing It is not necessary that the actual complaint be filed by the deadline date A timely motion to proceed in forma pauperis see I 4 102 or any other appropriate filing with the court will toll the deadline Moreover the Secretary will consider any complaint date stamped Received Tendered or any other such designation by the clerk of the court as filed within the appropriate 60 day period as timely even if the filing date is beyond the deadline In any case in which the complaint appears untimely the division clerk must phone

    Original URL path: http://www.severe.net/hallex4-131.html (2016-05-01)
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  • HALLEX - Severe.net
    or her administrative remedies before filing a civil action there is in most instances no right to judicial review and the analyst will complete an affidavit using the fill in draft in I 4 199 Exhibit F The failure to exhaust affidavit is the appropriate affidavit to complete when the Appeals Council or the ALJ has issued a dismissal order for a reason other than res judicata B Using the Fill in Draft Affidavit The analyst will insert all identifying information in the appropriate blank spaces Thereafter the analyst will set forth the complete case history Attach all relevant documents as exhibits to the affidavit If the claimant filed a civil action within 60 days see I 4 131 A of an ALJ decision but did not request Appeals Council review the analyst will conclude the affidavit with the following statement When as in the instant case the plaintiff files a civil action instead of a request for review within sixty 60 days of an Administrative Law Judge s decision it is the Appeals Council s policy to treat the civil action as a timely filed request for review following the court s dismissal When the claimant filed a court

    Original URL path: http://www.severe.net/hallex4-132.html (2016-05-01)
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  • HALLEX - Severe.net
    fill in draft res judicata affidavit in I 4 199 Exhibit G In reviewing the file the analyst must ensure that the ALJ and or Appeals Council appropriately applied the res judicata provisions of the regulations The analyst will be alert to recent legislative changes which may apply to the case In addition the analyst must verify the date last insured to ensure that there is no unadjudicated period B

    Original URL path: http://www.severe.net/hallex4-133.html (2016-05-01)
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  • HALLEX - Severe.net
    1 000 MEDICARE 2 000 IN PEER REVIEW ORGANIZATION PRO CASES A General When a claimant files a civil action on a Medicare claim the analyst must determine if the amount in controversy is at least 1 000 2 000 in PRO cases If it is not section 1869 b of the Act section 1155 of the Act in PRO cases does not authorize judicial review and the analyst must

    Original URL path: http://www.severe.net/hallex4-134.html (2016-05-01)
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  • HALLEX - Severe.net
    a supporting affidavit For motions to remand if the remand request is for technical reasons the affidavit must describe the nature of the problem and what efforts SSA made to solve it e g search memoranda a tape audit etc If the motion requests remand for substantive reasons the affidavit must state what problem s is in record and what action the Appeals Council intends to take if the court grants the motion for remand Supporting documents for either technical or substantive remand requests are generally not necessary The analyst must ensure that the affidavit accompanies the HA 552 when the clerk releases it B Mandamus Actions When the claimant files a mandamus action and the case is within OHA s jurisdiction the analyst must prepare an affidavit The affidavit must describe what actions if any the Appeals Council and or ALJ has taken The affidavit must also describe any other facts relevant to those actions particularly any facts explaining delay e g letters returned by the U S Postal Service The analyst must include any supporting documents as exhibits see I 4 721 C Contempt Motions When OGC advises OHA that a claimant has filed a contempt motion and

    Original URL path: http://www.severe.net/hallex4-135.html (2016-05-01)
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  • HALLEX - Severe.net
    and return it to the analyst for review After the analyst has proofread the affidavit and attached the supporting documents he or she must place both copies of the affidavit in a separate folder with an affidavit route slip see I 4 199 Exhibit I showing the type of affidavit and the claimant s name and SSN and give it to the Division Director for signature An operating division clerk will then handcarry the file to the office of the Director OCA for notarization and return to the division Upon return of the affidavit to the division the clerk in the division must ä make seven photocopies of the signed original affidavit and eight copies of any attached exhibits ä place the original and one set of exhibits in a manila folder DO NOT STAPLE ä place the tissue copy and five photocopies in a second folder along with five sets of exhibit copies ä route both files to the OGC Answer Section with a route slip which shows the name of the person who prepared the affidavit ä place one copy of the affidavit and exhibits in the claim file and unless OGC instructs otherwise retain the file in

    Original URL path: http://www.severe.net/hallex4-136.html (2016-05-01)
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