TN 6 (08-94)

DI 33015.065 Example of Modification to Scheduling Notice When Another Hearing is Required Because DHO Who Held Hearing Becomes Unavailable to Write Decisions - Exhibits

EXHIBIT A - DOMESTIC CLAIM

We are writing about your (1).

The Disability Hearing Officer who held your hearing on (2) (3) . Since that Disability Hearing Officer is not available to make the decision on your case, we have scheduled another hearing for you. The hearing will be held:

 

Date: (4)

 

Time: (5)

 

Place: (6)

 

If You Need A Different Hearing Place Or Date

 

If you need a different time or place for the hearing, please call the Disability Hearing Unit right away. The number is (7) . Or you can call any Social Security office.

 

If You Do Not Want Another Hearing

 

If you do not want another hearing, we can make a decision using the information in your case file. Please call the Disability Hearing Unit or any Social Security office right away if you do not want another hearing.

 

Payment For The Cost of Travel To The Hearing

 

We can sometimes pay costs for travel to the hearing. You, your representative and any witnesses we decide are needed for the hearing can ask us to pay travel costs. We can pay costs for travel to the place of the hearing if the distance is more than 75 miles one way. We measure the distance from each person's home or office, whichever the person travels from.

We have a limit in how much we can pay your representative for travel costs. We cannot pay your representative more than a maximum amount set for the area (8) . If you or your representative want more information about this, please call the Disability Hearing Unit.

 

Asking For Payment Of Travel Costs

 

You or the person asking for payment must give the Disability Hearing Officer proof of the travel costs. The request for payment and proofs can be given at the hearing. If you expect to have unusual costs, call the Disability Hearing Unit right away. Some examples of unusual costs are: ambulance, attendant services, meals, lodging or taxicabs. The Disability Hearing Officer must approve payment for these unusual costs before the hearing, unless these costs are unexpected or unavailable.

 

Payment For Travel Costs Before The Hearing

 

If you need payment for travel costs before the hearing, contact the Disability Hearing Unit right away. If we pay the travel costs before the hearing, you must give the Disability Hearing Office proof of the actual costs within (9) days after your trip. If we pay you too much, you will have to pay back the extra money within (10) days from the day we tell you how much you owe.

 

If You Have Any Questions

 

If you have any questions, you should call the Disability Hearing Unit at the telephone number shown above. We can answer your questions over the phone.

You may also call, write or visit any Social Security office.

If you write any office, please be sure to include your claim number. If you visit any office, please take this letter with you. It will help us answer your questions.

 

Fill-ins:

 

1.

Choice 1:

Social Security case

 

Choice 2:

Supplemental Security Income case

 

Choice 3:

Social Security and Supplemental Security Income cases

2.

Date hearing was held, in the format “January 1, 1994”

3.

Reason DHO is not available to make the hearing decision.

4.

Date of new hearing, in the format “January 1, 1994”

5.

Time of the hearing

6.

Place of the hearing

7.

DHU phone number

8.

Choice 1:

USE: If State Agency Hearing Officer will hold the hearing:

  

“served by your hearing office”

 

Choice 2:

USE: If Federal Disability Officer will hold the hearing:

  

“where we hold the hearing”

9.

Choice 1:

20

 

Choice 2:

State time limit

10.

Choice 1:

20

 

Choice 2:

State time limit

 

EXHIBIT B - FOREIGN CLAIM

We are writing about your Social Security case.

The Disability Hearing Officer who held your hearing on (1) (2) . Since that Disability Hearing Officer is not available to make the decision on your case, we have scheduled another hearing for you. The hearing will be held:

 

Date: (3)

 

Time: (4)

 

Place: (5)

 

If You Need A Different Hearing Place or Date

 

If you need a different time or place for the hearing, please contact the Disability Hearing Unit right away.

The address of the Disability Hearing Unit is:

(6)

The phone number is (7) .

 

If You Do Not Want Another Hearing

 

If you do not want another hearing, we can make a decision using the information in your case file. Please contact the Disability Hearing Unit right away if you do not want another hearing.

 

Payment For The Cost Of Travel To The Hearing

 

We can sometimes pay costs for travel to the hearing. You, your representative and any witnesses we decide are needed for the hearing can ask us to pay travel costs. We can pay costs for travel in the United States if the distance is more than 75 miles one way. We measure the distance from the person's place of entry into the United States to the place where we hold the hearing. If the travel is only in the United States, we measure the distance from the person's home or office, whichever the person travels from.

We have a limit on how much we can pay your representative for travel costs. We cannot pay your representative more than a maximum amount set for the area where we hold the hearing. If you or your representative want more information about this, please contact the Disability Hearing Unit.

 

Asking For Payment Of Travel Costs

 

You or the person asking for payment must give the Disability Hearing Officer proof of the travel costs. The request for payment and proofs can be given at the hearing. If you expect to have unusual costs, contact the Disability Hearing Unit right away. Some examples of unusual costs are: ambulance, attendant services, meals, lodging or taxicabs. The Disability Hearing Officer must approve payment for these unusual costs before the hearing, unless these costs are unexpected or unavoidable.

 

Payment For Travel Costs Before The Hearing

 

If you need payment for travel costs before the hearing, contact the Disability Hearing Unit right away. If we pay the travel costs before the hearing, you must give the Disability Hearing Officer proof of the actual costs within 20 days after your trip. If we pay you too much, you will have to pay back the extra money within 20 days from the day we tell you how much you owe.

 

If You Have Any Questions

 

If you have any questions, you should call the Disability Hearing Unit at the telephone number shown above. We can answer your questions over the phone.

You may also contact (8) .

If you write any office, please be sure to include your claim number. If you visit any office, please take this letter with you. It will help us answer your questions.

 

Fill-ins:

1.

Date hearing was held, in the format “January 1, 1994”

2.

Reason DHO is not available to make the hearing decision.

3.

Date of new hearing, in the format “January 1, 1994”

4.

Time of the hearing

5.

Place of the hearing

6.

DHU Address

7.

DHU phone number

8.

Choice 1:

USE: If Consular code is 601

  

“the Veterans Affairs Regional Office, Social Security Division, 1131 Roxas Boulevard, Manila”

 

Choice 2:

USE: If Consular code is 953, 815, 816

  

“any Social Security office”

 

Choice 3:

USE: If Consular code is 704, 714, 734, 744, 754, 773, 774, 783, 793, 899

  

“any Social Security office or the nearest United States Embassy or consulate”

 

Choice 4:

USE: If Geographic code is 96001A

  

“any Social Security office or the nearest United States Embassy or consulate. Or, if you live in the Philippines, you may contact the Veterans Affairs Regional Office, Social Security Division, 1131 Roxas Boulevard, Manila”

 

Choice 5:

USE: If Consular or geographic code is not shown above

  

“the nearest United States Embassy or consulate”

NOTE: The Spanish versions of these notices are located at DI 33095.058.