6.3 Deadlines for Submitting Evidence Flashcards
“What is the SSA’s Five-Day Rule for submitting evidence?”
Answer: “Claimants must submit or inform SSA about additional evidence no later than five business days before an ALJ hearing.”
Explanation: “This rule ensures the ALJ has sufficient time to review the evidence before the hearing.”
Source: CFR §404.935.
“Are there exceptions to the Five-Day Rule?”
“Yes, exceptions include unforeseen events, lack of awareness of the evidence, or failure to timely obtain it despite diligent efforts.”
Explanation: “Claimants or representatives must demonstrate good cause to submit late evidence.”
“When should medical records be requested and submitted?”
“Records should be requested as early as possible and submitted promptly to avoid delays or non-compliance with deadlines.”
Explanation: “Timely submission is critical to avoid jeopardizing the case.”
Case Scenario: Emily’s ALJ hearing is scheduled for April 15, 2025. On April 13, she submits additional medical records that were unavailable earlier due to a delay from her doctor’s office.
Question: Can the ALJ consider Emily’s evidence?
Answer: Yes, the ALJ may consider the evidence if Emily provides good cause for the late submission, such as the delay caused by her doctor’s office.
Legal Explanation: Under the SSA’s Five-Day Rule, evidence must generally be submitted at least five business days before the hearing. Exceptions are allowed if the claimant demonstrates good cause.
Key Resource: CFR §404.935 – Rules for evidence submission and good cause exceptions.
Case Scenario: Michael attends his ALJ hearing but brings new medical evidence to submit at the hearing. He claims he did not know earlier that the evidence would be necessary.
Question: Will the ALJ accept this evidence?
Answer: The ALJ may accept the evidence if Michael demonstrates good cause for not submitting it earlier, such as lack of awareness or inability to obtain the records in time.
Legal Explanation: Good cause exceptions to the Five-Day Rule include unforeseen circumstances or lack of knowledge about the evidence’s importance.
Key Resource: CFR §404.935(b) – Good cause for late evidence submission.
Deadlines:
Evidence must generally be submitted at least five business days before the ALJ hearing, with good cause exceptions.
