TN 2 (07-93)
GN 03107.150 Field Office (FO) Responsibilities (EAP)
1. Requirements for EAP
SSA will not entertain a claimant's request to proceed under EAP unless:
He/she, following the receipt of a reconsideration determination or hearing decision, indicates in some way that the denial of benefits was due to a provision of the law which he/she believes to be unconstitutional, and
He/she also meets the requirements in GN 03107.100D.1.
2. EAP Explained
When a claimant seeks to use EAP, the FO must explain to him/her the following:
EAP is a voluntary and alternative procedure to the usual administrative appeals process.
IMPORTANT: Be sure the claimant understands that the right to pursue the issue through the usual administrative appeals process will be curtailed once a formal agreement is signed by both parties.
To qualify for EAP all of the requirements in
GN 03107.100D.1. must be met.
Once all parties have signed the agreement, there is no provision for withdrawal from the agreement.
When an EAP request is denied, as in the case where a pertinent eligibility factor cannot be resolved in favor of the claimant, he/she will be notified that EAP does not apply.
The denied EAP request is then treated as a request for a hearing or AC review, as appropriate, and sent to the Office of Disability Adjudication and Review (ODAR).
NOTE: No appeal rights are retained with a denied EAP request.
He/she has 60 days from the date the agreement is received, signed on behalf of the Commissioner, to file a civil action in the U.S. District Court.
If no civil action is filed then the last finding by SSA will be the final determination or decision in the case.
Address and document any additional questions the claimant may have.
B. Procedure - Claimant Proceeds With EAP
1. Claimant's Written Statement
If, after explaining the requirements, the claimant decides to proceed with EAP, then the FO will:
Obtain a signed statement indicating that he/she:
Received an explanation of EAP.
Agrees that the requirements in GN 03107.100D.1. are met; and
Wishes to enter into an EAP agreement.
Retain a copy of the EAP request until the EAP “agreement” prepared by CO (GN 03107.250B.1) is signed by all the parties or EAP is denied.
2. Review of Entitlement Factors
Review for eligibility factors before forwarding an EAP request to the PC. Review the claims folder to ascertain that all pertinent eligibility factors which might preclude receipt of benefits have been resolved in favor of the claimant. This is necessary because a court will take jurisdiction of an EAP case only if a constitutional issue prevents the payment of benefits.
NOTE: Any overpayment resulting from a disputed constitutional issue will need to be resolved before EAP can apply.
3. Routing EAP Request
Send the EAP request with the claims folder to the appropriate PC, ATTN: Reconsideration and Disability Review Branch, for review.
C. Procedure - Premature EAP Request
A premature EAP request may be received at any level of the appeals process. Depending on the level of review, handle as indicated below:
1. Prior to a Reconsideration Determination
Prior to a reconsideration determination, the FO will:
Advise the claimant that the issue must first be pursued through the reconsideration level.
Document the claims folder that the claimant is interested in pursuing EAP in that he/she wants to skip further administrative appeals and proceed directly to court.
2. Administrative Law Judge (ALJ) Hearing Decision
The FO will forward the EAP request to the hearing office where the decision is pending. ODAR has jurisdiction to approve or deny an EAP request when a request for hearing has been filed and a final decision of the Commissioner has not been issued.
3. AC Review Pending
Once a claim is pending AC review, the FO will explain to the claimant that there is no real advantage to request EAP. It normally takes less time to await an AC decision than file a civil action.
However, if the claimant insists on proceeding with EAP then, without any further action, the FO will forward the request to:Social Security Administration
Office of Disability Adjudication and Review
Attention: Office of the Executive Director, Suite 1400
1 Skyline Tower
5107 Leesburg Pike
Falls Church, VA 22041-3255
The Deputy Chair of the AC will make the determination if the criteria for EAP are met.
D. Procedure - Finaliz