DI 42010.005 Receipt of Hearing Requests
A. Association and transmittal of hearing requests
Notices of hearing requests having been filed in disability claims are forwarded to ODO or the PSC where the related claims folder is serviced. The request is associated with the folder and transmitted directly to the servicing ALJ office unless:
The hearing request is filed before reconsideration.
A “flag” is contained in the file directing that if a hearing request is filed, the folder must be forwarded to the appropriate Recon Staff.
A new application for interim RIB award (SSA) has been filed with the hearing request.
An inquiry is received that ODO must handle.
The folder is charged to a DDS or DO (e.g., for development of a reopening action).
In the first four situations above, notice of the hearing request and folder will be forwarded to the appropriate Recon Staff for processing per DI 42005.005 H. If the folder is not available, as in the fifth situation, the hearing request along with any other “A” freeze material will also be forwarded to the appropriate Recon Staff.
If you receive a withdrawal of a hearing request, send it to the ALJ handling the case in accordance with GN 03103.210.
B. Request for hearing received by letter or other correspondence
A request for hearing may be received from the claimant, a duly appointed representative or other authorized individual (e.g., Members of Congress) by letter or other correspondence. The DO or PC should prepare an HA-501-U5 from this information. Type the name of the person making the request in the space for signature. It is not necessary in this situation to obtain the claimant's signature on the HA-501-U5. Enter under “reasons for disagreement” that the request was made by letter indicating from whom the letter was received and the date of the letter. Attach the letter to the original of the HA-501-U5 and a legible copy of the letter to each copy of the HA-501-U5.
The date of receipt of the letter or the mailing date is considered the date of filing the hearing request. (See GN 03103.020 for use of the mailing date as the filing date.) Distribute the copies as in GN 03103.020.
The DO should contact the claimant and explain his right to appear at the hearing per GN 03103.010.
C. Letter asks for hearing form
If a letter is received from a claimant asking for a form on which to request a hearing, the DO will send HA-501-U5 (HA-5011-U6) if a Part A, Hospital Insurance claim is involved). (If such a letter is received by the PSC, INTPSC, Office of Disability Operations (ODO) or Office of Central Records Operations (OCRO), they will send it to the DO.) Include an SSA-1696-U4 for completion if the claimant has a representative and an SSA-1696-U4 has not already been filed.
As in B. above, the date of receipt of the letter or the mailing date is considered the date of filing.
The transmittal letter to the claimant or his representative should request the information set forth in GN 03103.010, and remind the claimant of the requirement that the request be filed within a certain time frame. If the request for hearing is filed, attach the letter requesting the form to the ALJ's copy of the HA-501-U5. The DO should also contact the claimant and explain his right to appear at the hearing per GN 03103.010.
D. Hearing request filed before request for reconsideration or before reconsideration action is complete
(See DI 42005.005H.)
E. Hearing request filed - folder in ODO/DRS - reopening or other adjudicative action taken
1. Prior determination reversed
Where a reopening is made prior to receipt and association of the hearing request and a favorable determination results, prepare an SSA-3583-U2 in the usual way (see GN 03103.110 and DI 42005.005H.).
In the Remarks portion insert the following: “A favorable determination was made on reopening before the request for hearing was received. A copy of the award will be sent to you shortly.”
Send the Hearing Request file copy to the ALJ without the folder: place the Claims Folder copy in the folder on the right side: send a copy to ODO and the Control Copy with a check in the block provided to the Office of Central Records Operation (OCRO).
Process the approved determination to payment. Insert “136C 137S” in the “LTR/PAR NO.” space of the revised determination and attach an SSA-865 to the original determination form. On this SSA-865 form, instruct the Typing unit to send a copy of the award notice to the ALJ by OF-41. On the SSA-865 also furnish that Unit with special language to insert on the OF-41 as to the onset date alleged by the claimant and the onset date established. Include also a statement that the favorable determination was made before receipt and association of the hearing request.
2. Prior determination modified
Where an unfavorable determination was made on reopening before receipt and association of the hearing request (i.e., the basis of the prior determination was changed, but the conclusion of “no disability” remains unchanged), send the applicant notice of the revised determination (NL 00601.150). Include the hearing paragraph (omitting the word “reconsideration”) and inform the applicant that since he or she has already requested a hearing on the prior determination, we are forwarding his or her case to the ALJ.
In this situation, the ALJ will consider both the reconsideration and reopening determinations. Follow the guides in B. above for transmitting the folder to the ALJ.
3. Prior determination affirmed without change
Where both the end result and basis of the prior determination have not been changed, send a letter of explanation to the applicant only where he submitted additional evidence or information and is expecting to learn the result of our review action. In this instance inform the applicant briefly that the information which he submitted does not warrant a change in the determination (date of reconsideration letter) and that such determination remains in effect. Also inform him that since he has requested a hearing, we are forwarding his case to the ALJ. Following this, transmit the file to the ALJ in accordance with B. above. Where no letter to the applicant is required, send the related folder to the ALJ in the same manner.