TN 13 (08-97)
DI 12015.004 Change of Address Cases - Policy
Claimants whose initial disability determinations are made under the FPM process are offered a hearing as the first level of appeal for disability issues.
A. Policy - Jurisdiction — Determining When a Case Remains a FPM Case and When It Does Not
The chart below shows when a case drops out of the test because of a change of address.
|Situation: Claimant moves from...||Drops out of test?|
|DDS FPM test site to an address not served by any DDS FPM site||YES|
|DDS FPM test site to another FPM DDS test site||NO|
|FFPM test site outside of the State of Arizona (WNPSC DTU cases) or service area of the Lexington or Richmond, KY FO (ODIO cases)||YES|
NOTE: A claim drops out of the test if the claimant moves from a DDS FPM test site to a FFPM test site or vice versa, or from the ODIO test site to the WNPSC FFPM test site or vice versa. A claim does not drop out of the test if the claimant moves from the service area of one Kentucky FO to that of another, e.g., from Richmond to Lexington.
B. Policy - Appeals for Cases No Longer in the FPM Test
When a claim drops out of the test, the FPM test processes listed in DI 12015.003 no longer apply. The level of appeal of the initial determination is determined by the level in the appeals process which is applicable when the claim drops out of the test. There are two scenarios:
A claimant in the FPM requests an appeal of the initial determination prior to dropping out of the test. In this situation, the claimant is already at the hearing before his/her claim moves from the FPM test process to the regular process. The claim will not revert back to the reconsideration level when the claim moves into the current process.
A claimant previously in the FPM has not requested an appeal of his/her determination prior to dropping out of the test. In this situation, the claimant's next level of appeal is to a reconsideration regardless of the fact that he/she may have received a notice stating that the next level of appeal was to a hearing.