TN 3 (07-23)

GN 03107.150 Field Office (FO) Expedited Appeals Process (EAP) Responsibilities

Citations: 20 C.F.R. Sections 404.923 - 404.928; 416.1423 - 416.1428

A. Policy

This section outlines the duties and responsibilities of the FO in handling an EAP request under Title II and Title XVI. The FO is only responsible for initiating an EAP request if the request is submitted after the reconsideration determination but before a request for hearing. If a request for hearing has been filed and an Administrative Law Judge (ALJ) decision has not been issued, the Office of Hearings Operations (OHO) has jurisdiction to handle the EAP request pursuant to Hearings, Appeals, and Litigation Law Manual (HALLEX) I-2-2-25. If an ALJ decision has already been issued or a claim is pending Appeals Council (AC) review, the Office of Appellate Operations (OAO) has jurisdiction to handle the EAP request pursuant to HALLEX I-3-0-65. For guidance on when a FO receives an EAP request after a hearing request, see GN 03107.150C in this section.

1. Requirements for EAP

The Social Security Administration (SSA) will not grant a claimant's request to proceed under the EAP unless:

  • After receiving a reconsideration determination or hearing decision, the claimant indicates in writing that the only factor preventing a favorable determination or decision is a provision in the law that the claimant believes to be unconstitutional, and

  • The claimant also meets the requirements in GN 03107.100C.1.

    IMPORTANT: If the claimant disputes the facts of the determination or decision, even because of a constitutional issue, the claimant must use the regular administrative appeals process.

2. EAP explained

When a claimant seeks to use the EAP, the FO must explain to the claimant the following:

  • To qualify for EAP, all of the requirements in GN 03107.100C.1 must be met.

  • EAP is a voluntary and alternative process to the regular administrative appeals process.

  • Once all parties have signed the agreement, there is no provision for withdrawal from the agreement.

    IMPORTANT: Be sure the claimant understands that once all parties have signed the EAP agreement, the claimant will have no further appeal rights within the administrative appeals process.

  • If SSA denies the EAP request, as in the case where the claimant does not meet all necessary requirements, the claimant will receive written notice that EAP does not apply. The denial of EAP request will be considered as a request for hearing. The FO will send the request to the servicing hearing office. For more information on denial of an EAP request, see GN 03107.150B.2.b in this section.

    NOTE: Denial of request to use the EAP is not an initial determination. It is not subject to administrative or judicial review.

  • After the claimant signs the EAP agreement, the claimant may file an action in a federal district court within 60 days after the claimant receives a copy of the agreement signed by the Deputy Commissioner of the Office of Analytics, Review, and Oversight, SSA's authorized representative.

  • If the claimant fails to timely file a civil action, the claimant will have no further appeal rights, either within the administrative appeals process or in federal court, unless the AC finds good cause for late filing, see GN 03106.005.

B. Procedure - Claimant proceeds with the EAP request

1. Claimant's statement

After the FO explains the EAP as set forth in GN 03107.150A.2 above, if the claimant decides to proceed with the EAP, the FO will:

  1. a. 

    Obtain the claimant's written statement on SSA-795 (Statement of Claimant or Other Person), letter, facsimile, or email indicating that the claimant:

    • Wishes to enter into an EAP agreement;

    • Received an explanation of EAP as set forth in GN 03107.150A.2; and

    • Agrees that the requirements in GN 03107.100C.1 are met.

  2. b. 

    Upload a copy of EAP request and the claimant's written statement to the electronic folder, such as eView or the Evidence Portal (EP), whichever appropriate.

  3. c. 

    Using an SSA-5002 (Report of Contact), address and document any additional questions the claimant may have.

2. Review of requirements

The Claims Specialist (CS) is responsible for initiating the EAP request and ensuring that the claim meets all requirements for using the EAP. The Claims Technical Expert (CTE) is responsible for additional review and concurring with the CS’s conclusion regarding the EAP request. The CS and CTE will review the claim to confirm that all pertinent eligibility and entitlement factors have been resolved.

NOTE: In the absence of the CTE, an Operations Supervisor (OS) may serve as a back-up for additional review and concurrence.

 

  1. a. 

    If the claim meets all of the requirements in GN 03107.100C.1, the FO will forward the EAP request and other pertinent documents to the servicing Regional Office (RO).

    • If the claim is a paper claims folder, the FO mails the paper folder, including the EAP request and other pertinent documents, to the servicing RO, Attention: Center of Disability and Program Support (CDPS).

    • If the claim is an electronic claims folder, the FO emails the EAP request and other pertinent documents to CDPS Controls inbox for the servicing RO.

    NOTE: Do not delay initiating the EAP request when there is a pending overpayment resulting from a disputed constitutional issue. For guidance on overpayments, see GN 02200.000 or SI 02200.000.

    The RO will review the EAP request and confirm that it satisfies the EAP requirements. If the RO is satisfied that the claim meets the criteria for the EAP, the RO will prepare the EAP agreement per GN 03107.250B.1. The RO will then forward the agreement to the FO. The FO will obtain the claimant’s signature on two copies of the agreement. If the claimant signs the agreement, the FO will mail both original signed agreements to the RO. For more information on RO EAP responsibilities, see GN 03107.250. For more information on FO EAP responsibilities, see GN 03107.150D.1 in this section.

  2. b. 

    If the claim does not meet all of the requirements in GN 03107.100C.1, the FO will advise the claimant (and representative, if any) by written notice, see NL 00703.471, that:

    • The EAP does not apply, and

    • SSA considers a denied EAP request to be a request for hearing.

      NOTE: In the notice, include the address of the servicing hearing office where the claims folder was sent. Do not add an appeal paragraph as denying the use of EAP is not an initial determination.

    If appropriate, after the notice has been mailed, load the appeal through the normal business process by establishing the appeal in Modernized Claims System (MCS), Modernized SSI Claims System (MSSICS), and Electronic Disability Collect System (EDCS).

    Forward the claims folder to the servicing hearing office. For more information on forwarding the folder to the servicing hearing office, see GN 03103.080, SI 04030.030, or DI 12010.010.

C. Procedure - EAP request premature or outside FO jurisdiction

SSA may receive an EAP request at any level of the appeals process. Depending on the level of review, the FO will handle the request as indicated below:

1. Before a reconsideration determination

If a claimant inquires about EAP before receiving a reconsideration determination, the FO will explain to the claimant that the claim must be pursued at least through the reconsideration level before the claimant may submit an EAP request. Do not take a statement requesting EAP before the reconsideration determination is made.

2. ALJ hearing decision pending

OHO has jurisdiction to approve or deny an EAP request when the claim is pending at the hearing level. If the FO receives an EAP request when a request for hearing has been filed and a hearing decision has not been issued, the FO will upload the EAP request into the electronic folder, such as eView or EP, whichever is appropriate, and then forward the EAP request to the hearing office where the request for hearing is pending.

For more information on OHO EAP procedures, see HALLEX I-2-2-25.

3. AC review pending

If an ALJ decision has already been issued or the claim is pending review by the AC, OAO will handle the EAP request. If the FO receives an EAP request when an ALJ decision has already been issued or when AC review is pending on the claim, the FO will upload the EAP request into the electronic folder, such as eView or EP, whichever is appropriate, and then email the EAP request to OAO at ^DCARO.OAO with "Expedited Appeals Process (EAP) Request" in the subject line.

For more information on OAO EAP procedures, see HALLEX I-3-0-65.

D. Procedure - Finalizing an EAP request

1. EAP agreement received from the RO

When the FO receives a cover memorandum and the EAP agreement prepared by the RO per GN 03107.250B.1, the FO must make two copies of the agreement and make every effort to obtain the claimant’s pen-and-ink (wet) signature on both copies of the EAP agreement within 30 days.

NOTE: The FO will retain a copy of the EAP agreement that it received from the RO until the claimant has signed the EAP agreement, the claimant cancels the EAP request, or SSA cancels the EAP request.

If the FO does not obtain the claimant’s signature within 30 days, the FO will document the reason signature was not obtained and return the cover memorandum, along with the unsigned EAP agreement, to the RO. For more information on FO responsibilities when a claimant fails to respond, or refuses to sign the EAP agreement, see GN 03107.150D.5 in this section.

The FO can extend the 30-day deadline if there is indication that the claimant will sign the agreement. The FO must advise the RO of any extension given.

For more information on FO and RO responsibilities when the claimant has signed the EAP agreement, see GN 03107.150D.6 in this section and GN 03107.250B.5.a.

2. Representative involved

If the claimant has a representative, the FO will work with the representative to obtain the claimant's signature on the EAP agreement.

IMPORTANT: The claimant must sign the agreement. A representative may not sign the EAP agreement on the claimant's behalf.

3. All parties have not yet signed the EAP agreement and claimant no longer wishes to pursue the EAP

After the claimant submits the written EAP request, the claimant may decide not to pursue the EAP further. As long as all parties have not yet signed an EAP agreement, the FO will:

  • Explain to the claimant that SSA will mail a cancellation notice to the claimant, and the claimant must request a hearing within 30 days of receiving the notice or no further appeal will be available. The period may be extended if the claimant shows good cause for missing the deadline. For more information on good cause for extending the time limit to file an appeal, see GN 03101.020. SSA presumes that the claimant receives the notice five days after SSA mails it;

  • Explain to the claimant that the reconsideration determination will become the final determination in the case;

  • Document the above explanation and the claimant's acknowledgement using SSA-5002 (Report of Contact);

  • Obtain the claimant’s signed (pen-and-ink signature) statement on SSA-795 (Statement of Claimant or Other Person) indicating that the claimant does not wish to pursue the EAP further;

    NOTE: Technicians should check emergency messages (EM) to determine if there have been any temporary changes to signature requirement. For more information on statement(s) or opinions of claimant(s) or other person(s), see GN 00301.305.

  • Retain a copy of the SSA-5002 and the claimant’s signed statement in the electronic folder, such as eView or EP, whichever is appropriate;

  • Send a cancellation notice to the claimant (and representative, if any). For cancellation request sample language, see NL 00703.472; and

  • Notify the RO that the claimant does not wish to pursue the EAP further and forward the pertinent documentation.

    NOTE: The FO does not need to notify the RO of the cancellation request if the FO has not yet forwarded the EAP request to the RO to prepare the EAP agreement.

4. Claimant objects to the wording of the agreement

If the FO cannot obtain the claimant's signature because the claimant objects to the wording of the agreement, the FO should obtains alternative language proposed by the claimant and immediately (within 10 days) submits the claimant's alternative language to the RO.

For RO responsibilities when a claimant objects to the wording of the EAP agreement, see GN 03107.250B.3.

5. Claimant fails to respond, or refuses to sign the EAP agreement

After the FO makes every effort but cannot obtain the claimant's signature on the EAP agreement because the claimant fails to respond or refuses to sign, the FO will make two telephone attempts to contact the claimant at two different time of the day or on two different days.

a. If the telephone attempts are successful, the FO will:

  • Explain to the claimant that SSA will mail a closeout notice to the claimant, and the claimant must either sign the EAP agreement or request a hearing within 30 days of receiving the notice. If the claimant does neither, no further appeal rights will be available, either within the administrative appeals process or in federal court. The period will be extended if the claimant shows good cause for missing the deadline. For more information on good cause for extending the time limit to file an appeal, see GN 03101.020. SSA presumes that the claimant receives the notice five days after SSA mails it;

  • Explain to the claimant that the reconsideration determination will become the final determination in the case;

  • Using an SSA-5002 (Report of Contact), document the above explanation and the claimant’s acknowledgement;

  • Retain a copy of the SSA-5002 in the electronic folder, such as eView or EP, whichever is appropriate; and

  • Document the reason the FO could not obtain the claimant’s signature, and return the cover memorandum along with the unsigned EAP agreement to the RO.

NOTE: If the FO provides the explanation to the claimant and the claimant now indicates intent to sign the agreement, the FO must advise the RO of the extension.

b. If the telephone attempts are unsuccessful, the FO will:

  • Using an SSA-5002, document all calls and attempts to contact the claimant.

  • Retain a copy of the SSA-5002 in the electronic folder, such as eView or EP, whichever is appropriate; and

  • Document the reason the FO could not obtain the claimant’s signature, and return the cover memorandum along with the unsigned EAP agreement to the RO.

For RO responsibilities when a claimant fails to respond, or refuses to sign the EAP agreement, see GN 03107.250B.5.b.

6. Claimant signs the EAP agreement

After the claimant has signed two copies of the EAP agreement, the FO will mail both original signed agreements to the RO. The FO will retain a copy of the signed agreement in the electronic folder, such as eView or EP, whichever is appropriate.

For RO responsibilities when a claimant signs the EAP agreement, see GN 03107.250B.5.a.

7. Claimant seeks representation

If the claimant expresses interest in having an attorney represent the claimant in filing the civil action in federal district court, follow the instructions in GN 03910.030.

E. References

  • GN 03107.100 Title II Expedited Appeals Process (EAP) – Overview

  • SI 04060.010 Title XVI Expedited Appeals Process (EAP) – Overview

  • GN 03107.250 Regional Office (RO) Expedited Appeals Process (EAP) Responsibilities

  • GN 03101.020 Good Cause for Extending the Time Limit to File an Appeal

  • NL 00703.471 Expedited Appeals Process (EAP) is Denied

  • NL 00703.472 Claimant Cancels Request For Expedited Appeals Process (EAP)

  • HALLEX I-2-2-25 Expedited Appeals Process – Constitutional Challenge to Social Security Act

  • HALLEX I-3-0-65 Expedited Appeals Process – Constitutional Challenge to Social Security Act

  • GN 03103.080 Forwarding the Form HA-501-U5 (Request for Hearing by Administrative Law Judge) and Folder to the Servicing Hearing Office

  • SI 04030.030 Title XVI Instructions for Forwarding the Form HA-501-U5 (Request for Hearing by Administrative Law Judge) and Folder to the Servicing Hearing Office

  • DI 12010.010 Assembly and Routing of Folders for Administrative Law Judge (ALJ) Hearing

  • GN 00301.305 Statement(s) or Opinions of Claimant(s) or Other Person(s)

  • GN 03910.030 Advising Claimants About Their Right to Representation


To Link to this section - Use this URL:
http://policy.ssa.gov/poms.nsf/lnx/0203107150
GN 03107.150 - Field Office (FO) Expedited Appeals Process (EAP) Responsibilities - 07/05/2023
Batch run: 10/23/2024
Rev:07/05/2023