Last Update: 9/08/05 (Transmittal I-3-36)
Pursuant to § 8001 of Pub. L. No. 100-647 (the Technical and Miscellaneous Revenue Act of 1988) which amended §§ 223 and 1631(a) of the Social Security Act to add §§ 223(h) and 1631(a)(8), if an ALJ issues a favorable decision the Social Security Administration (SSA) will pay the claimant interim benefits under the circumstances described in B. below.
NOTE:
The provisions of § 8001 are also applicable to favorable Senior Staff Attorney decisions.
If an ALJ issues a favorable decision SSA will pay the claimant interim benefits if:
The ALJ has issued a decision finding that the claimant is disabled under Title II or is disabled or blind under Title XVI (or continues to be disabled under Title II or disabled or blind under Title XVI); and
The Appeals Council has initiated review of the ALJ's decision on its own motion pursuant to §§ 404.969 or 416.1469; or
The Appeals Council reopens the favorable ALJ's decision pursuant to §§ 404.987 or 416.1487; and
110 days have elapsed after the date of the ALJ's decision; and
The Commissioner has not issued a final decision.
SSA will pay the claimant interim benefits under Title II for months beginning with the month before the month in which the 110th day after the date of the ALJ's decision expires, and under Title XVI for months beginning with the month in which the 110th day after the date of the ALJ's decision expires.
If SSA begins paying a claimant interim benefits, SSA will stop paying the interim benefits under Title II in the month before the month in which the Commissioner issues a final decision, and under Title XVI in the month in which the Commissioner issues a final decision.
We must include notice of this provision in Appeals Council remand orders and prepared-to-find/remand letters whenever the Council reviews an ALJ decision covered by the provisions of § 8001 on its own motion or reopens such a decision. Add the following language as the closing paragraph of both the remand orders and prepared-to-find/remand letters:
Section 8001 of Pub. L. No. 100-647 requires the payment of interim benefits in cases where an Administrative Law Judge issues a favorable disability decision and no final decision is issued within 110 days after the date of the Administrative Law Judge's decision. Because the Appeals Council has exercised its [(own motion review)(reopening)] authority in this case, interim benefits may be payable if a final decision is not issued within 110 days after the date of the Administrative Law Judge's decision. You will receive interim benefits until we issue a final decision. Those interim benefits will continue until a final decision is issued. Another Social Security Administration office will notify [(the claimant)(you)] at the appropriate time as to the amount and the effective date of any interim payments.
Interim benefits, when required, begin with the month before the month in which the 110th day after the date of the ALJ's decision expires in Title II cases, and begin with the month in which the 110th day after the date of the ALJ's decision expires in Title XVI cases. Analysts will annotate in red ink the remarks section of the route slip forwarding an own motion or reopening recommendation to the Appeals Council, “POTENTIAL 8001 CASE.” In addition, the analyst will route the claim file and appeals file to the Operations Management, Analysis and Coordination Staff (OMACS) in Room 1410, immediately after the Appeals Council releases its own motion or reopening notice. OMACS will set up controls and return the files to the OAO branch. When appropriate, OMACS will request the effectuating components to initiate or terminate interim benefit payments.