Federal Register / Vol. 62, No. 153 / Friday, August 8, 1997 / Notices 42851

evidence is submitted to SSA’s OHA by

claimants or their representatives in at

least 40 percent of claims pending at the

hearing level. (SSA requests or develops

for additional evidence in

approximately another 20 percent of

cases.) Given this volume of cases

involving additional evidence at the

hearing level, evaluation of these cases

by DDS medical and/or psychological

consultants could either result in a

revised favorable determination without

a hearing, or at least present a clearer

picture of the medical record for

purposes of a hearing before an ALJ in

a significant number of cases. For these

purposes, the ALJ would accept the DDS

medical and/or psychological

consultant’s analysis as evidence

material to the issues, pursuant to 20

CFR 404.944 and 416.1444.

Including the DDS medical and/or

psychological consultant’s analysis of

additional evidence in the record is

consistent with considering DDS

medical and psychological consultant

opinion in adjudication at the OHA

level (SSR 96–6p, 7/2/96). The analysis

is expected to help ensure uniform

decision making at all levels of

administrative review within SSA by

providing expert consideration of, and

opinion on, the medical issues

presented by the additional evidence,

including, but not limited to, the

existence and severity of the claimant’s

impairment(s), the existence and

severity of the claimant’s symptoms,

whether the impairment meets or equals

the requirements for any impairment

listed in 20 CFR Part 404, Subpart P,

Appendix 1, and the claimant’s residual

functional capacity. The analysis is also

expected to help OHA focus any

additional development it may consider

necessary by indicating what issues

raised in the additional evidence, if any,

could be clarified by such development.

Policy Interpretation: Under 20 CFR

404.941 and 416.1441, OHA may return

selected cases to the DDS for a

prehearing case review when new

medical evidence is received at the

hearing level.

OHA may return a case to the DDS if

all of the following criteria are met:

• The claimant requested a hearing

regarding his or her entitlement to

disability insurance benefits under title

II of the Social Security Act (the Act),

eligibility for supplemental security

income based on disability under title

XVI of the Act, or both;

• A hearing has not been held in the

case;

• SSA received additional evidence

in the case after the date of the

reconsideration determination;

• The additional evidence is not

duplicative and was not a result of SSA

development; and

• SSA has not previously returned

the case to the DDS for a prehearing case

review.

The DDS will decide whether its

determination may be revised based on

the additional evidence when

considered with the entire record. A

revised determination may be wholly or

partially favorable to the claimant.

If the DDS revises the determination,

SSA will mail written notice of the

revised determination to all parties to

the hearing at their last known address.

The notice will state the basis for the

revised determination, and will advise

all parties of their right to request a

hearing on the revised determination

within 60 days after the date of

receiving the notice.

If the DDS revises its determination to

a wholly favorable determination, the

notice will also state that:

• The ALJ will dismiss the request for

hearing unless the claimant or another

party requests that the hearing proceed;

and

• The request to proceed with the

hearing must be made in writing within

30 days after the date the notice of the

revised determination was mailed.

If the DDS revises its determination to

a partially favorable determination, the

notice will also state:

• What was not favorable in the

revised determination; and

• That the hearing requested by the

claimant will be held unless the

claimant and all other parties inform

SSA that they agree to dismiss the

hearing request.

If the DDS does not revise its

determination based on the additional

evidence, the DDS will return the case

to the ALJ with a medical and/or

psychological consultant’s analysis of

the entire medical record, including the

additional evidence, in a format

appropriate for inclusion into the

record. This analysis will be considered

opinion evidence from a nonexamining

source or sources, under the provisions

of the regulations at 20 CFR 404.1527(f)

and 416.927(f), and the guidelines in

SSR 96–6p. The ALJ must consider the

medical and/or psychological

consultant’s analysis by applying the

rules in paragraphs (a) through (e) of

those sections of the regulations, and

must explain in the decision the weight

given to the analysis.

Returning a case for a prehearing case

review will not delay the scheduling of

a hearing unless the claimant agrees to

continue the review and delay the

hearing. If the prehearing case review is

not completed before the date of the

hearing, the case will be sent to the ALJ

unless a favorable revised determination

is in process, or the claimant and the

other parties to the hearing agree in

writing to delay the hearing until the

review is completed.

EFFECTIVE DATE: This Ruling is effective

on August 8, 1997.

Cross-Reference: SSR 96–6p, ‘‘Titles II

and XVI: Consideration of

Administrative Findings of Fact by State

Agency Medical and Psychological

Consultants and Other Program

Physicians and Psychologists at the

Administrative Law Judge and Appeals

Council Levels of Administrative

Review; Medical Equivalence.’’

[FR Doc. 97–20900 Filed 8–7–97; 8:45 am]

BILLING CODE 4190–29–P

DEPARTMENT OF TRANSPORTATION

Aviation Proceedings, Agreements

Filed During the Week of August 1,

1997

The following Agreements were filed

with the Department of Transportation

under the provisions of 49 U.S.C 412

and 414. Answers may be filed within

21 days of date of filing.

Docket Number: OST–97–2775

Date Filed: July 31, 1997

Parties: Members of the International

Air Transport Association

Subject:

PTC Comp 0140 dated July 9, 1997

Mail Vote 880 (Reso 010v-Fares from

Zimbabwe)

1st Amendment to Mail Vote

2nd Amendment to Mail Vote

Intended effective date: August 15,

1997.

Docket Number: OST–97–2777

Date Filed: July 31, 1997

Parties: Members of the International

Air Transport Association

Subject:

PTC23 Telex Mail Vote 878

Mail Vote 878 (Reso 010t-Hong KongLondon Fares)

Amendment to Mail Vote

Intended effective date: August 15,

1997.

Paulette V. Twine,

Chief, Documentary Services.

[FR Doc. 97–20963 Filed 8–7–97; 8:45 am]

BILLING CODE 4910–62–P