Effective Dates: 09/01/2022 - Present Previous | Next

TN 17 (09-22)

DI 33015.065 Example of Modification to Scheduling Notice When Another Hearing is Required Because DHO Who Held Hearing Becomes Unavailable to Write Decisions - Exhibits

EXHIBIT A - DOMESTIC CLAIM

We are writing about your (1).

The Disability Hearing Officer who held your hearing on (2) (3) . Since that Disability Hearing Officer is not available to make the decision on your case, we have scheduled another hearing for you. The hearing will be held:

 

Date: (4)

 

Time: (5)

 

Place: (6)

 

If You Need A Different Hearing Place Or Date

 

If you need a different time or place for the hearing, please call the Disability Hearing Unit right away. The number is (7) . Or you can call any Social Security office.

 

If You Do Not Want Another Hearing

 

If you do not want another hearing, we can make a decision using the information in your case file. Please call the Disability Hearing Unit or any Social Security office right away if you do not want another hearing.

 

Payment For The Cost of Travel To The Hearing

 

We can sometimes pay costs for travel to the hearing. You, your representative and any witnesses we decide are needed for the hearing can ask us to pay travel costs. We can pay costs for travel to the place of the hearing if the distance is more than 75 miles one way. We measure the distance from each person's home or office, whichever the person travels from.

We have a limit in how much we can pay your representative for travel costs. We cannot pay your representative more than a maximum amount set for the area (8) . If you or your representative want more information about this, please call the Disability Hearing Unit.

 

Asking For Payment Of Travel Costs

 

You or the person asking for payment must give the Disability Hearing Officer proof of the travel costs. The request for payment and proofs can be given at the hearing. If you expect to have unusual costs, call the Disability Hearing Unit right away. Some examples of unusual costs are: ambulance, attendant services, meals, lodging or taxicabs. The Disability Hearing Officer must approve payment for these unusual costs before the hearing, unless these costs are unexpected or unavailable.

 

Payment For Travel Costs Before The Hearing

 

If you need payment for travel costs before the hearing, contact the Disability Hearing Unit right away. If we pay the travel costs before the hearing, you must give the Disability Hearing Office proof of the actual costs within (9) days after your trip. If we pay you too much, you will have to pay back the extra money within (10) days from the day we tell you how much you owe.

 

Need More Help?

 

1. If you have any questions, you should call the Disability Hearing Unit at the telephone number shown above. We can answer your questions over the phone.

2. Visit www.ssa.gov for fast, simple, and secure online service.

3. Call us at 1-800-772-1213, weekdays from 8:00 am to 7:00 pm. If you are deaf or hard of hearing, call TTY 1-800-325-0778. Please mention this letter when you call

4. You may also call your local office at (11) (Field Office General Inquiry Line phone number).

(12) (Office name)

(13)

(14)

(15)

(16)

(17)

 

 

How Are We Doing? Go to www.ssa.gov/feedback to tell us.

 

Fill-ins:

  1. 1. 

    Case

    Choice 1: Social Security case

    Choice 2: Supplemental Security Income case

    Choice 3: Social Security and Supplemental Security Income cases

  2. 2. 

    Date hearing was held, in the format "January 1, 2022"

  3. 3. 

    Reason DHO is not available to make the hearing decision.

  4. 4. 

    Date of new hearing, in the format "January 1, 2022"

  5. 5. 

    Time of the hearing

  6. 6. 

    Place of the hearing

  7. 7. 

    DHU phone number

  8. 8. 

    Hearing site

    Choice 1: If State Agency Hearing Officer will hold the hearing: USE "served by your hearing office"

    Choice 2: If Federal Disability Officer will hold the hearing: USE "where we hold the hearing"

  9. 9. 

    Travel cost time frame

    Choice 1: 20

    Choice 2: State time limit

  10. 10. 

    Travel cost time frame

    Choice 1: 20

    Choice 2: State time limit

  11. 11. 

    FO Phone contact info

    Choice 1 – Business Number from DOORS (Preferred choice when present)

    Choice 2 – T2 Number from DOORS for T2 Notices (Use only when Business Number is not present)

    Choice 3 – T16 Number from DOORS for SSI Notices (Use only when Business Number is not present)

  12. 12. 

    Line 1 of FO Address in DOORS

  13. 13. 

    Line 2 of FO Address in DOORS

  14. 14. 

    Line 3 of FO Address in DOORS

  15. 15. 

    Line 4 of FO Address in DOORS

  16. 16. 

    Line 5 of FO Address in DOORS

  17. 17. 

    Line 6 of FO Address in DOORS

    Choice 1 - Line 6 of FO Address in DOORS

    Choice 2 – Null (use when address is less than 6 lines)

 

EXHIBIT B - FOREIGN CLAIM

We are writing about your Social Security case.

The Disability Hearing Officer who held your hearing on (1) (2) . Since that Disability Hearing Officer is not available to make the decision on your case, we have scheduled another hearing for you. The hearing will be held:

 

Date: (3)

 

Time: (4)

 

Place: (5)

 

If You Need A Different Hearing Place or Date

 

If you need a different time or place for the hearing, please contact the Disability Hearing Unit right away.

The address of the Disability Hearing Unit is:

(6)

The phone number is (7) .

 

If You Do Not Want Another Hearing

 

If you do not want another hearing, we can make a decision using the information in your case file. Please contact the Disability Hearing Unit right away if you do not want another hearing.

 

Payment For The Cost Of Travel To The Hearing

 

We can sometimes pay costs for travel to the hearing. You, your representative and any witnesses we decide are needed for the hearing can ask us to pay travel costs. We can pay costs for travel in the United States if the distance is more than 75 miles one way. We measure the distance from the person's place of entry into the United States to the place where we hold the hearing. If the travel is only in the United States, we measure the distance from the person's home or office, whichever the person travels from.

We have a limit on how much we can pay your representative for travel costs. We cannot pay your representative more than a maximum amount set for the area where we hold the hearing. If you or your representative want more information about this, please contact the Disability Hearing Unit.

 

Asking For Payment Of Travel Costs

 

You or the person asking for payment must give the Disability Hearing Officer proof of the travel costs. The request for payment and proofs can be given at the hearing. If you expect to have unusual costs, contact the Disability Hearing Unit right away. Some examples of unusual costs are: ambulance, attendant services, meals, lodging or taxicabs. The Disability Hearing Officer must approve payment for these unusual costs before the hearing, unless these costs are unexpected or unavoidable.

 

Payment For Travel Costs Before The Hearing

 

If you need payment for travel costs before the hearing, contact the Disability Hearing Unit right away. If we pay the travel costs before the hearing, you must give the Disability Hearing Officer proof of the actual costs within 20 days after your trip. If we pay you too much, you will have to pay back the extra money within 20 days from the day we tell you how much you owe.

 

Need More Help?

 

1. If you have any questions, you should call the Disability Hearing Unit at the telephone number shown above. We can answer your questions over the phone.

2. Visit www.ssa.gov for fast, simple, and secure online service.

3. If you are in the United States, American Samoa, Guam, Northern Mariana Islands, Puerto Rico, or the U.S. Virgin Islands, call us at 1-800-772-1213. If you are deaf or hard of hearing, call TTY 1-800-325-0778.

4. You may also call your local Social Security office.  

 

If you are outside the United States or its territories:  

  • •

    If you are in Canada, visit (8) to find the office that services your area. 

  • •

    Contact your nearest Federal Benefits Unit (FBU). Visit (9) for a list of FBUs.

  • •

    Write to the Social Security Administration at:

    P.O. Box 17769 Baltimore, Maryland 21235-7769, USA

 

If you contact us, please refer to this letter. It will help us answer your questions.

 

How Are We Doing? Go to www.ssa.gov/feedback to tell us.

 

 

Fill-ins:

  1. 1. 

    Date hearing was held, in the format“January 1, 2022”

  2. 2. 

    Reason DHO is not available to make the hearing decision.

  3. 3. 

    Date of new hearing, in the format “January 1, 2022”

  4. 4. 

    Time of the hearing

  5. 5. 

    Place of the hearing

  6. 6. 

    DHU Address

  7. 7. 

    DHU phone number

  8. 8. 

    www.ssa.gov/foreign/canada.htm

  9. 9. 

    www.ssa.gov/foreign/foreign.htm

NOTE: The Spanish versions of these notices are located at DI 33095.058.

To Link to this section - Use this URL:
http://policy.ssa.gov/poms.nsf/lnx/0433015065
DI 33015.065 - Example of Modification to Scheduling Notice When Another Hearing is Required Because DHO Who Held Hearing Becomes Unavailable to Write Decisions - Exhibits - 09/01/2022
Batch run: 09/01/2022
Rev:09/01/2022