TN 4 (12-06)

GN 03102.325 PC Reconsideration Processing Procedures

A. Policy

The Reconsideration Reviewer or Senior Claims Processing Specialist will review or develop only evidence which is necessary to render a correct reconsideration determination of the issue(s) being protested (and any other entitlement issues).

B. Procedure

1. Acknowledge Request

The PC will send a notice modeled after acknowledging receipt of appeal if the PC receives a reconsideration request directly.

2. Claimant Requests Information

If the claimant is merely asking for information, do not process as an appeal.

Send a letter to the claimant responding to the request for information and include a statement that the claimant should let us know if he or she was also asking that we take an appeal.

If the SSA-561-U2 is only requesting information, dismiss the reconsideration request and then provide the requested information to the individual.

3. Request Dismissed

If the request is dismissed because it was not timely filed, there was no good cause, or the contested issue was not an initial determination, send a dismissal notice explaining the reason(s) for dismissal. Do not include the appeal paragraph because a dismissal is final and cannot be appealed.

4. Developing Unrelated Issues

Develop the issue if it will not delay issuing the reconsideration determination. Otherwise:

  • Issue the reconsideration determination;

  • Refer the case to a claims authorizer (CA) and document reason for the referral;

  • Request the CA to effectuate the reconsideration determination, resolve the issue, and prepare any necessary notices.

5. Delayed Determination

If the case will not be reviewed within 30 days of last contact with the claimant or the issue involves a question under consideration by OGC, or other component, notify the claimant that his or her case is being reconsidered and that we will send a notice when a determination is made.

If the case involves reconsideration of an overpayment determination and/or waiver relief and claimant's benefits are currently withheld to recover the overpayment in question, notify the claimant that:

  • his or her case is being reconsidered;

  • benefits will be resumed starting with current operating month;

  • benefits already withheld will still be withheld until all issues are resolved; and

  • we will send a notice when a determination is made.

6. Withdrawal Of Request For Reconsideration

Notify the claimant of the decision. If the request is approved, inform claimant that withdrawal can be canceled by filing a written request with SSA within 60 days after date claimant receives this notice. See GN 03102.200B.6.

7. Claimant Dies

In the event of claimant death, process the death termination. If there are no other parties, dismiss the request for reconsideration unless there is an overpayment on the record with no waiver request. A reconsidered determination should be rendered since recovery from the estate is possible. See GN 03102.200B.5.


To Link to this section - Use this URL:
http://policy.ssa.gov/poms.nsf/lnx/0203102325
GN 03102.325 - PC Reconsideration Processing Procedures - 05/21/2014
Batch run: 05/21/2014
Rev:05/21/2014