[Federal Register Volume 62, Number 186 (Thursday, September 25, 1997)]
[Proposed Rules]
[Pages 50266-50270]
From the Federal Register Online via the Government Publishing Office [www.gpo.gov]
[FR Doc No: 97-25365]
=======================================================================
-----------------------------------------------------------------------
SOCIAL SECURITY ADMINISTRATION
20 CFR Parts 404 and 416
RIN 0960-AE53
Administrative Review Process; Identification and Referral of
Cases for Quality Review Under the Appeals Council's Authority To
Review Cases on Its Own Motion
AGENCY: Social Security Administration.
ACTION: Proposed rules.
-----------------------------------------------------------------------
SUMMARY: We propose to amend our regulations to include the rules under
which a decision or order of dismissal that is issued after the filing
of a request for a hearing by an administrative law judge (ALJ) will be
referred to the Appeals Council for possible review under the Appeals
Council's existing authority to review cases on its own motion. The
proposed rules concern identification and referral procedures that we
currently follow to ensure the accuracy of decisions at the ALJ-hearing
step (hearing level) of the administrative review process, and new
quality assurance procedures that we are proposing under the Plan for a
New Disability Claim Process approved by the Commissioner of Social
Security in September 1994 (59 FR 47887). The procedures set forth in
the proposed rules apply to dispositions at the hearing level of the
administrative review process that are made by ALJs, and also to
dispositions at the hearing level that are not made by ALJs but are
subject to review under the Appeals Council's own-motion authority. The
latter type of dispositions currently consist of wholly favorable
decisions issued by attorney advisors and adjudication officers.
DATES: To be sure that your comments are considered, we must receive
them no later than November 24, 1997.
ADDRESSES: Comments should be submitted in writing to the Commissioner
of Social Security, P.O. Box 1585, Baltimore, MD 21235; sent by telefax
to (410) 966-2830; sent by E-mail to ``[email protected]''; or,
delivered to the Division of Regulations and Rulings, Social Security
Administration, 3-B-1 Operations Building, 6401 Security Boulevard,
Baltimore, MD 21235, between 8:00 A.M. and 4:30 P.M. on regular
business days. Comments may be inspected during these same hours by
making arrangements with the contact person shown below.
FOR FURTHER INFORMATION CONTACT: Harry J. Short, Legal Assistant,
Division of Regulations and Rulings, Social Security Administration,
6401 Security Boulevard, Baltimore, MD 21235, (410) 965-6243 for
information about these rules. For information on eligibility or
claiming benefits, call our national toll-free number, 1-800-772-1213.
SUPPLEMENTARY INFORMATION:
Background
Under procedures set forth in Secs. 404.967 ff. and 416.1467 ff.,
and pursuant to a direct delegation of authority from the Commissioner
of Social Security (see 61 FR 35844, 35852, July 8, 1996), the Appeals
Council, a component in our Office of Hearings and Appeals (OHA),
reviews hearing decisions and orders of dismissal issued by ALJs of the
Social Security Administration (SSA). The Appeals Council may review a
decision or dismissal action of an ALJ at the request of a party to the
action or, under authority provided in Secs. 404.969 and 416.1469, on
its own motion. Through the exercise of its authority to review cases,
the Appeals Council is responsible for ensuring that the final
decisions of the Commissioner of Social Security under titles II and
XVI of the Social Security Act (the Act), as amended, are proper and in
accordance with the law, regulations, and binding agency policy.
The Appeals Council's authority to review cases on its own motion
also applies, at present, to two types of hearing-level cases that do
not result in decisions by ALJs. Under Secs. 404.942 and 416.1442,
attorney advisors of OHA are temporarily authorized to conduct certain
prehearing proceedings and to issue, where warranted by the documentary
evidence, wholly favorable decisions. Under the provisions of
Secs. 404.942 (e)(2) and (f)(3) and 416.1442 (e)(2) and (f)(3), such
decisions are subject to review under the own-motion authority of the
Appeals Council established in Secs. 404.969 and 416.1469. In addition,
under Secs. 404.943 and 416.1443, adjudication officers are authorized,
for test purposes, to conduct certain prehearing proceedings and to
issue, where warranted by the documentary evidence, wholly favorable
decisions. Under the provisions of Secs. 404.943(c)(2)(ii) and
416.1443(c)(2)(ii), such decisions are also subject to review on the
Appeals Council's own motion.
Under our regulations on the Appeals Council's procedures, if the
Appeals Council decides to review a case in response to a request for
review or on its own motion, it may issue a decision or remand the case
to an ALJ. The Appeals Council may also dismiss a request for hearing
for any reason that the ALJ could have dismissed the request.
A decision by the Appeals Council ``to review'' a hearing-level
decision means that the Appeals Council assumes jurisdiction to cause
that decision not to be the final decision of the Commissioner of
Social Security. A decision that the Appeals Council ``reviews'' will
be replaced by a new final action in the case, either by a decision or
dismissal order of the
[[Page 50267]]
Appeals Council or, if a hearing or other hearing-level proceedings are
required, by a decision or dismissal order issued following remand of
the case from the Council to an ALJ.
A decision by the Appeals Council to review a case is made when,
following a preliminary consideration of all aspects of the case to
determine if review is appropriate, the Council issues a notice
announcing a decision to review. The Council's standard notice of
review advises the parties of the reasons for the review and (unless
the Council issues a wholly favorable decision upon taking review) the
issues to be considered in proceedings before the Council or before an
ALJ on remand. In instances in which the Council reviews a hearing
level decision that has been issued based on the documentary evidence
without the holding of an oral hearing by an ALJ, the parties have the
right to such a hearing, except where the parties waive that right in
writing.
The existing provisions in Secs. 404.969 and 416.1469 on the
Appeals Council's authority to review cases on its own motion provide
that the Appeals Council itself may decide to review a case within 60
days after the date of the hearing decision or dismissal and that, if
the Council does review a case under this authority, it will provide
notice to the parties to the hearing decision or dismissal action.
Sections 404.969 and 416.1469 do not currently address the procedures
we use in identifying and referring cases to the Appeals Council for it
to consider for possible review on its own motion.
The Appeals Council has broad authority to review any case on its
own motion pursuant to Secs. 404.969 and 416.1469. The conditions under
which the Appeals Council will review a case, on request for review or
on its own motion, are set forth in Secs. 404.970 and 416.1470. Those
sections provide that the Council will review a case if: (1) There
appears to be an abuse of discretion by the ALJ; (2) there is an error
of law; (3) the action, findings or conclusions of the ALJ are not
supported by substantial evidence; or (4) there is a broad policy or
procedural issue that may affect the general public interest. Sections
404.970 and 416.1470 further provide that the Council will also review
a case if new and material evidence is submitted that relates to the
period on or before the date of the ALJ's decision and the Council
finds, upon evaluating the evidence of record and the additional
evidence, that an action, a finding or a conclusion of the ALJ is
contrary to the weight of the evidence currently of record as a whole.
In fiscal year 1996 (FY '96), the Appeals Council received 99,735
requests for review filed by parties to the actions of ALJs. Most of
the requests were for review of unfavorable decisions and dismissal
actions; some concerned partially favorable decisions. In FY '96, the
Council also considered 8,602 cases for possible review on its own
motion. Almost all of these cases involved favorable hearing-level
decisions that were referred to the Appeals Council under one of two
types of identification and referral procedures we currently use--
random sample procedures, which generated the majority of this workload
in FY '96, and ``protest'' procedures.
Existing Identification and Referral Procedures
Section 304(g) of Public Law 96-265 (1980) required SSA to
implement a program for initiating review of ALJ decisions in
disability claims. Under section 304(g), the Appeals Council considers,
for possible review on its own motion, a national random sample of
favorable ALJ decisions that have not been implemented, and, as
resources permit, a random sample of unappealed denial decisions and
dismissals. (See Social Security Ruling 82-13.)
The Appeals Council also considers, for possible review on its own
motion, a random sample of wholly favorable decisions issued by
attorney advisors under the time-limited provisions of Secs. 404.942
and 416.1442. Wholly favorable decisions issued by adjudication
officers under the testing provisions of Secs. 404.943 and 416.1443 are
also identified by random sampling for referral to the Appeals Council
for possible own-motion review. These procedures have been established
in accordance with commitments we made, in publishing the final rules
for the attorney advisor and adjudication officer provisions, to assess
carefully the quality of the decisions issued by the attorney advisors
and the adjudication officers (see 60 FR 34127 and 60 FR 47471,
respectively).
Our existing identification and referral procedures also include
those under which the SSA components responsible for implementing
hearing-level decisions--SSA Processing Centers (PCs) and Field Offices
(FOs)--refer (``protest'') certain cases to the Appeals Council for
possible review under its own motion authority. The PCs, which include
our Program Service Centers and the Office of Disability and
International Operations, refer cases directly to the Appeals Council;
FOs forward cases to a PC or an SSA Regional Office, which decides if
the PC or the Regional Commissioner should make a referral to the
Council.
The decisions of ALJs and the decisions currently issued by
attorney advisors and adjudication officers are subject to referral to
the Appeals Council under our protest procedures. Almost all protested
decisions are favorable decisions because almost all of the ALJ
decisions that require implementation are wholly or partially favorable
decisions under which benefit payments are to be effectuated (initiated
or continued), and because all decisions issued by attorney advisors
and adjudication officers are favorable. In protesting a decision, an
effectuating component may recommend that the decision be made more or
less favorable or unfavorable.
Effectuating components refer a case if the need for referral is
believed to be clear (not dependent on a judgment factor) because of
one of the following circumstances: (1) The decision contains a
clerical error which affects the outcome of the claim; (2) the decision
is clearly contrary to the Act, regulations or rulings; or (3) the
decision cannot be effectuated because its intent is unclear as to an
issue affecting the claim's outcome.
Effectuating components refer cases to the Appeals Council by
written memoranda. If the Council decides to review a referred case, it
provides the parties a copy of the effectuating component's referral
memorandum with the notice by which it advises the parties that it will
review the case.
We are proposing to amend our regulations to include rules on the
existing random sample and protest procedures discussed above. We have
decided to propose rules setting forth these procedures in connection
with our decision to propose, in furtherance of the Plan for a New
Disability Claim Process, that the Appeals Council's own-motion
functions be strengthened by establishment of a new process for
identifying and referring cases for possible review under the Council's
existing own-motion authority.
New Identification and Referral Procedures
The Appeals Council currently considers only a small percentage of
all favorable decisions issued at the hearing level for possible review
under its own-motion authority. (In FY '96, the Council's workload in
this area represented fewer than 3 percent of such decisions in that
year.) In addition, the processes we currently use to select decisions
for possible review on the Appeals Council's own motion are generally
not designed to identify, in
[[Page 50268]]
any systematic way, hearing-level decisions that are likely to be
incorrect. The random sample processes bringing cases before the
Appeals Council do not identify cases other than by techniques designed
to assure randomness of selection within broadly identified categories
(i.e., allowances, unappealed denials, and dismissals). The
identification of ``protest'' cases that occurs in the effectuation
process is a secondary function of a process that is principally
focused on the prompt payment of benefits.
Based on the above considerations, we are proposing to establish
procedures under which our Office of Program and Integrity Reviews
(OPIR), the SSA component that oversees the review of State agency
determinations made under section 221(c) of the Act, will examine
certain allowance decisions at the hearing level and refer to the
Appeals Council the decisions that may not be supported by the record.
Decisions that have been issued at the hearing level will be included
in the OPIR-conducted examination process by random sampling and, as we
develop the computer systems and other technical capacities needed to
support this function, selective sampling that will rely on case
profiling and other sampling techniques to identify cases that involve
problematic issues or fact patterns that increase the likelihood of
error.
Under the proposed process, upon referral of a case by OPIR, the
Appeals Council would consider the case and OPIR's reasons for
believing the decision is not supported by the record and decide
whether to review the case in accordance with Secs. 404.969-404.970
and/or 416.1469-416.1470. If the Appeals Council decides to review an
OPIR-referred case, it would provide the parties a copy of OPIR's
referral with its notice of review. The 60-day time limit for the
Appeals Council to initiate review of a case under the authority and
standards provided in Secs. 404.969-404.970 and 416.1469-416.1470 would
apply to cases the Council considers for review in response to
referrals from OPIR.
Section 304(g) of Public Law 96-265 (see above) does not specify
the kind of identification and referral procedures that SSA should use
in implementing a program for initiating review of ALJ decisions in
disability cases. We believe that use of the new procedures we are
proposing, in combination with the existing identification and referral
procedures that we are proposing to regulate, would be consistent with
the kind of review contemplated by section 304.
An important purpose of the new procedures we are proposing is to
increase our ability to identify policy issues that should be clarified
through publication of regulations or rulings. We plan to monitor how
our policies are understood and implemented by post-adjudicative
evaluation of cases that are shown, as a result of their referral to
the Appeals Council, to pose significant policy or program issues.
Proposed Regulations
We propose to revise Secs. 404.969 and 416.1469, the regulations
that set forth the Appeals Council's authority to review cases on its
own motion, to state that we refer cases to the Appeals Council for it
to consider reviewing on its own motion. As proposed for revision,
Secs. 404.969 and 416.1469 describe the identification and referral
procedures we will follow and the action of the Appeals Council in
cases it considers for possible review on its own motion.
Sections 404.969 and 416.1469 as proposed will apply to all cases
that our regulations make subject to review on the Appeals Council's
own motion. These currently include, in addition to cases involving ALJ
decisions and dismissals, cases involving wholly favorable decisions
issued by attorney advisors under the time-limited provisions of
Secs. 404.942 and 416.1442, and cases involving wholly favorable
decisions issued by adjudication officers under the test procedures set
out in Secs. 404.943 and 416.1443.
Proposed Secs. 404.969(b) and 416.1469(b) specify that we will
identify a case for referral to the Appeals Council for possible review
under its own-motion authority before we effectuate a decision in the
case. These sections also provide that we will identify cases for
referral through random and selective sampling techniques, that we may
use these techniques in association with examination of the cases
identified by sampling, and that we will also identify cases for
referral through the evaluation of cases we conduct in order to
effectuate decisions.
Under Secs. 404.969(b)(1) and 416.1469(b)(1) as proposed, we may
conduct random and selective sampling of cases involving all types of
actions that occur at the hearing level of the administrative review
process (i.e., wholly or partially favorable decisions, unfavorable
decisions, or dismissals) and any type of title II or title XVI
benefits (i.e., different types of benefits based on disability and
benefits not based on disability). Our decision to propose these rules
rests on our conclusion that we should increase the number of favorable
disability decisions the Appeals Council considers for possible review
on its own motion to better balance review of favorable and unfavorable
decisions. However, the Council's existing authority to review cases on
its own motion covers all types of title II and title XVI cases
adjudicated at the hearing level, and these proposed rules will allow
use of the identification and referral procedures being set forth with
respect to all such cases.
Sections 404.969(b)(1) and 416.1469(b)(1) as proposed specify that
we will use selective sampling to identify cases that exhibit
problematic issues or fact patterns that increase the likelihood of
error. Under the provisions as proposed, the factors considered in
selective sampling will not include the identity of the decisionmaker
or the identity of the office issuing the decision.
Proposed Secs. 404.969(b)(1) and 416.1469(b)(1) also authorize but
do not require that we examine cases that have been identified through
random or selective sampling. Cases may be identified for referral by
random or selective sampling. The purpose of the examination of cases
that we may conduct is to refine the identification of cases in which
the action that has been taken is not supported.
Proposed Secs. 404.969(b)(2) and 416.1469(b)(2) provide that
effectuating components will identify cases for referral under criteria
presently used to identify clear error and circumstances preventing
effectuation of a decision. Any type of decision requiring effectuation
may be identified for referral under these provisions.
Under Secs. 404.969(c) and 416.1469(c), as proposed, we will make
referrals that occur as the result of a case examination or the
effectuation process in writing. The written referral will state the
referring component's reasons for believing that the Appeals Council
should review the case on its own motion. Sections 404.969(c) and
416.1469(c) as proposed also provide that referrals resulting from
selective sampling without a case examination may be accompanied by a
written statement identifying the issue(s) or fact pattern that caused
the referral, and that referrals resulting from random sampling without
a case examination will only identify the case as a random sample case.
A statement of the issue(s) or fact pattern identified in selective
sampling may be computer generated.
Proposed Secs. 404.969(d) and 416.1469(d) specify that the Appeals
Council's notice of review will include a copy of any written referral
provided
[[Page 50269]]
to the Appeals Council. These provisions also include language to state
clearly our long-standing policy that issuance of the notice of review
establishes when a decision to conduct a review occurs.
We are also proposing to include in Secs. 404.969(d) and
416.1469(d) a statement specifying our policy that, when the Appeals
Council is unable to decide whether to review a case on its own motion
within the 60-day period in which it may do so, it may consider whether
the decision should be reopened under the provisions of Secs. 404.987
and/or 416.1487, which authorize the Council to reopen a final decision
on its own initiative or at the request of a party to the decision, if
a condition for reopening stated in Secs. 404.988 and/or 416.1488 is
present. We are including this statement in the regulations to clarify
our long-standing policy that the Appeals Council may also reopen final
decisions in accordance with Secs. 404.987 and 416.1487 after the 60
days for initiating review under Secs. 404.969 and 416.1469 have
expired.
Electronic Version
The electronic file of this document is available on the Federal
Bulletin Board (FBB) at 9:00 a.m. on the date of publication in the
Federal Register. To download the file, modem dial (202) 512-1387. The
FBB instructions will explain how to download the file and the fee.
This file is in WordPerfect and will remain on the FBB during the
comment period.
Regulatory Procedures
Executive Order 12866
We have consulted with the Office of Management and Budget (OMB)
and determined that these rules do meet the criteria for a significant
regulatory action under Executive Order 12866. They were therefore
submitted to OMB for review.
Regulatory Flexibility Act
We certify that these regulations will not have a significant
economic impact on a substantial number of small entities because these
rules affect only individuals. Therefore, a regulatory flexibility
analysis as provided in the Regulatory Flexibility Act, as amended, is
not required.
Paperwork Reduction Act
These regulations impose no new reporting or record keeping
requirements requiring OMB clearance.
(Catalog of Federal Domestic Assistance Program Nos. 96.001, Social
Security-Disability Insurance; 96.002, Social Security-Retirement
Insurance; 96.003, Social Security-Special Benefits for Persons Aged
72 and Over; 96.004, Social Security-Survivors Insurance; 96.006,
Supplemental Security Income)
List of Subjects
20 CFR Part 404
Administrative practice and procedure, Death benefits, Disability
benefits, Old-Age, Survivors and Disability Insurance, Reporting and
recordkeeping requirements, Social Security.
20 CFR Part 416
Administrative practice and procedure, Aged, Blind, Disability
benefits, Public assistance programs, Supplemental Security Income
(SSI), Reporting and recordkeeping requirements.
Dated: September 12, 1997.
John J. Callahan,
Acting Commissioner of Social Security.
For the reasons set out in the preamble, subpart J of part 404 and
subpart N of part 416 of chapter III of title 20 of the Code of Federal
Regulations are proposed to be amended as set forth below.
PART 404--FEDERAL OLD-AGE, SURVIVORS AND DISABILITY INSURANCE
(1950- )
20 CFR part 404, subpart J, is amended as follows:
1. The authority citation for subpart J of part 404 is revised to
read as follows:
Authority: Secs. 201(j), 205 (a), (b), (d)-(h), and (j), 221,
225, and 702(a)(5) of the Social Security Act (42 U.S.C. 401(j), 405
(a), (b), (d)-(h), and (j), 421, 425, and 902(a)(5)); 31 U.S.C.
3720A; sec. 304(g), Pub. L. 96-265, 94 Stat. 456 (42 U.S.C. 421
note); sec. 5, Pub. L. 97-455, 96 Stat. 2500 (42 U.S.C. 405 note);
secs. 5, 6 (c)-(e), and 15, Pub. L. 98-460, 98 Stat. 1802 (42 U.S.C.
421 note).
2. Section 404.969 is revised to read as follows:
Sec. 404.969 Appeals Council initiates review.
(a) General. Anytime within 60 days after the date of a decision or
dismissal that is subject to review under this section, the Appeals
Council may decide on its own motion to review the action that was
taken in your case. We may refer your case to the Appeals Council for
it to consider reviewing under this authority.
(b) Identification of cases. We will identify a case for referral
to the Appeals Council for possible review under its own-motion
authority before we effectuate a decision in the case. We will identify
cases for referral to the Appeals Council through random and selective
sampling techniques, which we may use in association with examination
of the cases identified by sampling. We will also identify cases for
referral to the Appeals Council through the evaluation of cases we
conduct in order to effectuate decisions.
(1) Random and selective sampling and case examinations. We may use
random and selective sampling to identify cases involving any type of
action (i.e., wholly or partially favorable decisions, unfavorable
decisions, or dismissals) and any type of benefits (i.e., benefits
based on disability and benefits not based on disability). We will use
selective sampling to identify cases that exhibit problematic issues or
fact patterns that increase the likelihood of error. Our selective
sampling procedures will not identify cases based on the identity of
the decisionmaker or the identity of the office issuing the decision.
We may examine cases that have been identified through random or
selective sampling to refine the identification of cases in which the
action taken may not be supported by the record.
(2) Identification as a result of the effectuation process. We may
refer a case requiring effectuation to the Appeals Council if the
decision cannot be effectuated because it contains a clerical error
affecting the outcome of the claim; the decision is clearly
inconsistent with the Social Security Act, the regulations, or a
published ruling; or the decision is unclear regarding a matter that
affects the claim's outcome.
(c) Referral of cases. We will make referrals that occur as the
result of a case examination or the effectuation process in writing.
The written referral based on the results of such a case examination or
the effectuation process will state the referring component's reasons
for believing that the Appeals Council should review the case on its
own motion. Referrals that result from selective sampling without a
case examination may be accompanied by a written statement identifying
the issue(s) or fact pattern that caused the referral. Referrals that
result from random sampling without a case examination will only
identify the case as a random sample case.
(d) Appeals Council's action. If the Appeals Council decides to
review a decision or dismissal on its own motion, it will mail a notice
of review to all the parties as provided in Sec. 404.973. The Appeals
Council will include with that notice a copy of any written referral it
has received under paragraph (c) of this section. The Appeals Council's
decision
[[Page 50270]]
to review a case is established by its issuance of the notice of
review. If it is unable to decide within the applicable 60-day period
whether to review a decision or a dismissal, the Appeals Council may
consider the case to determine if the decision or dismissal should be
reopened pursuant to Sec. 404.987.
PART 416--SUPPLEMENTAL SECURITY INCOME FOR THE AGED, BLIND, AND
DISABLED
20 CFR part 416, subpart N, is amended as follows:
1. The authority citation for subpart N is revised to read as
follows:
Authority: Sec. 702(a)(5), 1631, and 1633 of the Social Security
Act (42 U.S.C. 902(a)(5), 1383, and 1383b); sec. 304(g), Pub. L. 96-
265, 94 Stat. 456 (42 U.S.C. 421 note).
2. Section 416.1469 is revised to read as follows:
Sec. 416.1469 Appeals Council initiates review.
(a) General. Anytime within 60 days after the date of a decision or
dismissal that is subject to review under this section, the Appeals
Council may decide on its own motion to review the action that was
taken in your case. We may refer your case to the Appeals Council for
it to consider reviewing under this authority.
(b) Identification of cases. We will identify a case for referral
to the Appeals Council for possible review under its own-motion
authority before we effectuate a decision in the case. We will identify
cases for referral to the Appeals Council through random and selective
sampling techniques, which we may use in association with examination
of the cases identified by sampling. We will also identify cases for
referral to the Appeals Council through the evaluation of cases we
conduct in order to effectuate decisions.
(1) Random and selective sampling and case examinations. We may use
random and selective sampling to identify cases involving any type of
action (i.e., wholly or partially favorable decisions, unfavorable
decisions, or dismissals) and any type of benefits (i.e., benefits
based on disability and benefits not based on disability). We will use
selective sampling to identify cases that exhibit problematic issues or
fact patterns that increase the likelihood of error. Our selective
sampling procedures will not identify cases based on the identity of
the decisionmaker or the identity of the office issuing the decision.
We may examine cases that have been identified through random or
selective sampling to refine the identification of cases in which the
action taken may not be supported by the record.
(2) Identification as a result of the effectuation process. We may
refer a case requiring effectuation to the Appeals Council if the
decision cannot be effectuated because it contains a clerical error
affecting the outcome of the claim; the decision is clearly
inconsistent with the Social Security Act, the regulations, or a
published ruling; or the decision is unclear regarding a matter that
affects the claim's outcome.
(c) Referral of cases. We will make referrals that occur as the
result of a case examination or the effectuation process in writing.
The written referral based on the results of such a case examination or
the effectuation process will state the referring component's reasons
for believing that the Appeals Council should review the case on its
own motion. Referrals that result from selective sampling without a
case examination may be accompanied by a written statement identifying
the issue(s) or fact pattern that caused the referral. Referrals that
result from random sampling without a case examination will only
identify the case as a random sample case.
(d) Appeals Council's action. If the Appeals Council decides to
review a decision or dismissal on its own motion, it will mail a notice
of review to all the parties as provided in Sec. 416.1473. The Appeals
Council will include with that notice a copy of any written referral it
has received under paragraph (c) of this section. The Appeals Council's
decision to review a case is established by its issuance of the notice
of review. If it is unable to decide within the applicable 60-day
period whether to review a decision or dismissal, the Appeals Council
may consider the case to determine if the decision or dismissal should
be reopened pursuant to Sec. 416.1487.
[FR Doc. 97-25365 Filed 9-24-97; 8:45 am]
BILLING CODE 4190-29-U