TN 43 (11-94)

DI 12594.015 Inquiries and Appeals

A. Policy

1. Appeal of Class Membership Decision

  1. An individual who has been denied class membership including ones who were denied on the grounds that their requests were untimely and not excused for “good cause” may appeal this decision, either through State of New York class counsel or directly to the Office of the General Counsel (OGC). Whenever possible, class membership disputes will be resolved between class counsel and OGC.

  2. Appeals of this decision will be referred to the United States District Court for the Southern District of New York for final decision.

2. Appeal of Readjudicated Determination

Class members whose claims are readjudicated under the State of New York review criteria have full appeal rights.

  • Appeals of all cases readjudicated by the DDS will be processed by an ALJ.

    EXCEPTION: Cases in which a current claim was pending at the initial level are combined with the State of New York case at the initial level, per DI 12594.010 .3.a. Appeals of these cases are processed by the DDS at the reconsideration level.

  • Appeals of all cases readjudicated by an ALJ will be processed by the Appeals Council.

B. Procedure

1. Inquiries - General

Respond to any inquiry regarding State of New York case. For inquiries regarding status of an individual's State of New York case, follow 2. below.

2. Inquiries About Status of State of New York Case

To reply to inquiries about the status of the State of New York Cases:

  1. If folder is in FO, associate inquiry with folder and respond in writing.

  2. If folder is not in FO:

    • Obtain a DDS-Q and, if the folder is in the DDS, get a status directly.

    • Otherwise, obtain status of case by sending an e:mail message to “¦¦N.Y. ARC POS DPB Policy at ~ S2D2.” The regional office coordinator will reply via e:mail or telephone.

      NOTE: NY State FOs only, refer to e:mail message #POS 93-95 dated 7/30/93.

    • Based on information provided by State of New York Coordinator, prepare and release written notice giving status of inquirer's State of New York case.

    • Forward inquiry and copy of response to current folder location. If case has not yet been alerted, send material to:

      SSA, ODIO
      ATTN: State of New York Coordinator
      P.O. Box 17369
      Baltimore, MD 21298-0050.

3. Appeal of Class Membership Decision

  1. If individual decides to appeal directly to OGC, complete SSA-795, indicating basis for appeal. Cover SSA-795, and any other documentation submitted, with OF-41, entering in Remarks section “Appeal of decision denying State of New York class membership.” Forward to:

    Office of General Counsel
    Social Security Division
    ATTN: State of New York Coordinator
    Altmeyer Building
    6401 Security Blvd.
    Baltimore, MD 21235-6401.
  2. If individual decides to appeal through class counsel, forward SSA-5002 and any other documentation submitted to:

    Cardiac Case
    Membership Unit
    Legal Services for the Elderly
    130 West 42nd Street
    17th Floor
    New York, NY 10036.

To Link to this section - Use this URL:
http://policy.ssa.gov/poms.nsf/lnx/0412594015
DI 12594.015 - Inquiries and Appeals - 06/27/2012
Batch run: 06/27/2012
Rev:06/27/2012