Citations:

Social Security Act, section 205(b);

20 CFR 404.914-404.918, 404.992, 404.993, 416.1413b, 416.1414- 416.1418, 416.1492, 416.1493, and 422.140

TN 6 (09-17)

DI 33001.001 The Disability Hearing Process — Title II and Title XVI

Citations:

Social Security Act, section 205(b);

20 CFR 404.914-404.918, 404.992, 404.993, 416.1413b, 416.1414-416.1418, 416.1492, , 416.1493, and 422.140

A. Introduction to the disability hearing process

1. Disability hearings and reopenings

This chapter addresses disability hearings at the reconsideration level of appeal. These procedures generally refer to reconsiderations of medical cessations, but they also include adverse reopening determinations.

2. Explanation of terms

When using these procedures, remember:

  • the terms “Disability Hearing Officer (DHO) reconsidered determination” and the “DHO hearing decision” are synonymous;

  • the term “Disability Hearing Unit (DHU)” means the separate adjudicatory Disability Determination Services (DDS) unit established for the purpose of processing disability hearing cases; and

  • the terms “supervisory hearing officer (SHO)” and “DHO” refer to the DDS counterpart for these functions.

3. Availability of disability hearings

Disability hearings are available at the reconsideration level of appeal in:

  • CDR medical cessation cases;

  • CDR reopenings that change only the basis for the cessation;

  • Adverse reopenings at the initial level (cases involving favorable initial CDR determinations which were reopened and revised to unfavorable or only partially favorable determinations) based on medical factors;

  • Adverse reopenings of cases involving favorable reconsideration CDR determinations which were reopened and which we propose to adversely revise based on medical factors.

NOTE: For additional information about the claimant’s right to a disability hearing at the medical CDR reconsideration level, refer to DI 29001.001. For DHO reopening policy, refer to DI 33020.025.

B. Federal and State disability hearings

We conduct hearings at both State and Federal levels. If you need to modify these procedures to conform to State business processes, you cannot modify them in any manner that would conflict with the Federal regulations governing disability hearings.

A Federal DHO may conduct hearings where SSA made the determination under appeal, such as railroad and foreign claims. The Associate Commissioner for the Office of Disability Determinations, or his or her delegate, appoints Federal DHOs. There may be circumstances when a Federal DHO assists State DHUs.

C. Who may conduct a disability hearing

Experienced disability adjudicators who have completed Social Security Administration (SSA) DHO training may conduct disability hearings. These individuals:

  • must have had no involvement in making the determination under appeal, i.e. the initial continuing disability review (CDR) cessation or adverse reopening, or the pre-hearing (PH) affirmation of the initial CDR cessation,
    and

  • are part of an adjudicatory unit of a state agency or Federal component (DHU) other than the adjudicatory unit that made the determination under appeal (DDS).

D. List of forms commonly used in disability hearing cases

Form

Form Title

OF-347

Order for Supplies or Services

SSA-381-SP

Waiver of Right to Receive Notices In Spanish

SSA-408

Route Slip

SSA-416

Medical Evaluation

SSA-454-BK

Continuing Disability Review Report

SSA-454-BK-SP

Continuing Disability Review Report - Spanish

SSA-533

Translation Request

SSA-567

Notice for Subsequent Handling

SSA-765

Response to Notice of Revised Determination

SSA-769-U4

Request for Change in Time/Place of Disability Hearing

SSA-770-U4

Notice Regarding Substitution of Party Upon Death of Claimant-Reconsideration of Disability Cessation

SSA-773-U4

Waiver of Right to Appear-Disability Hearing

SSA-789-U4

Request for Reconsideration-Disability Cessation Right to Appear

SSA-795

Statement of Claimant or Other Person

SSA-831

Disability Determination and Transmittal

SSA-832

Cessation or Continuance of Disability or Blindness Determination and Transmittal-Title XVI

SSA-833

Cessation or Continuance of Disability or Blindness Determination and Transmittal-Title II

SSA-887

Summary of Evidence

SSA-1128

Representative Involved

SSA-1204-BK

Disability Hearing Officer's Report of Disability Hearing (DC)

SSA-1205-BK

Disability Hearing Officer's Report of Disability Hearing

SSA-1207-BK

Disability Hearing Officer’s Decision (DIB, CDB, DWB (Including Surviving Divorced Spouse), DI, DS

SSA-1207-BK-OP1

Disability Hearing Officer’s Decision (Medical Improvement Review Standard Not Applicable)

SSA-1209-BK

Disability Hearing Officer’s Decision (Title XVI Disabled Child (DC)) – Continuing Disability Review

SSA-1272-U4

Subpoena-Disability Hearing

SSA-L1648-U2

Disability Hearing Decision Letter - Without Benefit Continuation - Auxiliary

SSA-L1656-U2

Disability Hearing Decision Letter - Benefit Continuation Elected at Reconsideration and Offered Again at Administrative Law Judge (ALJ) Hearing Level - Auxiliary

SSA-L1658-U2

Disability Hearing Decision Letter - Benefit Continuation Not Elected at Reconsideration and Offered Again at ALJ Hearing Level - Auxiliary

SSA-L1674-U2

Disability Hearing Decision Cover Letter - Without Benefit Continuation

SSA-L1675-U2

Disability Hearing Decision Cover Letter - Benefit Continuation Elected at Reconsideration and Offered Again at ALJ Hearing Level

SSA-L1677-U2

Disability Hearing Decision Cover Letter - Benefit Continuation Not Elected at Reconsideration and Offered Again at ALJ Hearing Level

SSA-L1678-U2

Disability Hearing Decision Cover Letter - Without Payment Continuation

SSA-L1679-U2

Disability Hearing Decision Cover Letter - Payment Continuation Not Elected at Reconsideration and Offered Again at ALJ Hearing Level

SSA-L1680-U2

Disability Hearing Decision Cover Letter - Payment Continuation Elected at Reconsideration and Offered Again at ALJ Hearing Level

SSA-L1696-U4

Appointment of Representative

SSA-2506-BK

Psychiatric Review Technique

SSA-2640

Disability Hearing Case

SSA-3031

Disability Hearing Review Sample Case Flag

SSA-3441-BK

Disability Report -- Appeal

SSA-3441-BK-SP

Disability Report – Appeal (Spanish)

SSA-4734-BK

Physical Residual Functional Capacity Assessment

SSA-4734-F4-SUP

Mental Residual Functional Capacity Assessment


To Link to this section - Use this URL:
http://policy.ssa.gov/poms.nsf/lnx/0433001001
DI 33001.001 - The Disability Hearing Process -- Title II and Title XVI - 09/28/2017
Batch run: 10/02/2017
Rev:09/28/2017