TN 1 (03-16)

DI 29001.010 Overview of Component Responsibilities Related to Medical Continuing Disability (CDR) Disability Hearings

A. Component responsibilities

The following chart describes the responsibilities of various components in the disability hearing process at the reconsideration level:

Component

Responsibilities

Field Office (FO)

  • Assists individuals with filing a Form SSA-789-U4 (Request for Reconsideration - Disability Cessation Right to Appear), and obtains all necessary supporting forms. For more information on these forms, see DI 12026.020B;

  • Sends these documents with the folder to the disability determination services (DDS), or the component responsible for developing non-State cases;

  • Serves as remote hearing site in order to provide accessible disability hearings to individuals who do not live within a reasonable distance of a DHU; and

  • Effectuates favorable reconsidered decisions.

Disability Determination Services (DDS)

  • Assigns the case to a pre-hearing examiner, who fully develops the case and reviews it for completeness with respect to each relevant issue;

  • Issues fully favorable reconsideration CDR determination if evidence warrants; and

  • Prepares folder for disability hearing and routes it to the DHU when unable to make a fully favorable determination.

Disability Hearing Unit (DHU)/ Disability Hearing Officer (DHO)

  • Schedules and holds hearing unless individual waived his or her right to appear. (If an individual waives the right to appear at a hearing or fails to appear, the DHO issues a decision based on the evidence in file, including any additional evidence submitted.)

    NOTE: If an individual fails to appear, the DHO must follow appropriate policy, which may require rescheduling the hearing (mental impairment involved, or good cause for not appearing).

  • Completes the appropriate disability determination and transmittal form SSA-831-U3, SSA-832, or SSA-833;

  • Issues a decision via a notice of reconsideration which provides administrative law judge (ALJ) appeal rights and, when appropriate, rights to statutory benefit continuation.

Review Components

  • Reviews the DDS' fully favorable reconsideration determinations. (Such determinations are subject to quality assurance review and, in Title II cases, to pre-effectuation review.); and

  • Returns case to the DDS for corrective action if the review indicates that the evidence does not warrant a fully favorable determination.

    NOTE: When the review component returns a case to the DDS, the DDS completes any necessary additional development and either prepares a revised (fully favorable) determination and returns the case to the review component, or prepares the folder for a disability hearing and forwards it to the DHU.

Great Lakes Program Service Center (GLPSC)

  • Processes career railroad and dependent annuitant cases;

  • Handles Request for Reconsideration-Disability Cessation in a manner similar to DDS procedure;

  • Forwards case to the DHO in the appropriate regional office (RO) if a hearing is necessary;

  • Effectuates determinations rendered by GLPSC or a DHO in coordination with the Railroad Retirement Board; and

  • Routes folder(s) to proper component for maintenance.

Office of Earnings and International Operations (OEIO)

  • Processes foreign claims in a manner similar to that described for the DDS;

  • The International Disability Unit (IDU) has its own DHO. Assist is sometimes requested from the Regional Office when the IDU DHO has had previous involvement in a particular claim (e.g., quality review); and

  • Effectuates reconsidered decisions issued in the OEIO.