TN 1 (11-00)
DI 42548.009 Case Routing – Office of Central Operations (OCO)
To the extent practicable, at each stage of merits adjudication, SSA shall accord priority to the cases entitled to relief under the October 21, 1999 order over other Hyatt III Implementation.
1. Primary subclass claim
Pending class claims are processed on a priority basis. See DI 42548.009B.8. Process Primary Subclass claims as follows:
a. DDS made last determination, initial or reconsideration:
If no SGA denial is possible:
If SGA denial is possible:
b. If the ALJ or AC made last decision:
Send to the servicing OHA hearing office
Use an SSA-559 to route the case.
2. Settlement subclass member
If the individual is a settlement subclass:
3. No Hyatt qualifying claim
If it is obvious that no claim qualifies for Hyatt Class relief, that is, there is no evidence claimant filed a claim for disability benefits or no final medical denial/termination by the NCDDS on or after 8/6/1990, and before 11/14/91:
Prepare an SSA-5002 explaining why claimant is not entitled to class relief.
Send the holder/folder by using route slip annotated “No Hyatt III eligible claim,” to OPB, Litigation Staff per DI 42548.008B.1.b.
4. Multiple claims
In multiple claim cases where at least one of the claims qualifies for Hyatt III Primary Subclass review then:
5. Subsequent non-class claim pending - class claim is a readjudication claim
Take the following actions when a subsequent non-class claim is pending in the DDS or OHA and at least one claim requires Hyatt III readjudication. (A readjudication claim is a class claim of an individual determined to be a Primary Subclass member or Settlement Subclass member entitled to a reopening.) See DI 42548.009B.8. for special priority instructions which apply when the class claim is a pending claim.
If the pending claim is at the initial or reconsideration level, send folder(s) to NCDDS via an SSA-559 annotated “Hyatt class member - associate with claim pending in your office and process in accordance with Hyatt consolidation procedure.”
If the pending claim is one for which an ALJ hearing has been requested by the claimant but has not yet been scheduled, send folder(s) to the appropriate hearing office via an SSA-559 annotated “Hyatt class member - ALJ hearing has been requested but not scheduled. Consolidate attached file with file in your office and forward to NCDDS in accordance with Hyatt consolidation procedure. If the DDS renders an adverse determination an ALJ hearing will be scheduled.”
If the pending claim is one for which an ALJ hearing has been scheduled but has not been held, send the folder(s) to the appropriate hearing office via an SSA-559 annotated “Hyatt class member - ALJ hearing has been scheduled. Consolidate attached file with file in your office in accordance with Hyatt consolidation procedure.”
If the pending claim is before the Appeals Council or is one for which an ALJ hearing has been held or an ALJ decision has been rendered, route folder(s) in accordance with DI 42548.009B.1. - the claims will not be consolidated.
NOTE: Do not consolidate unless all potential Hyatt claim files have been retrieved. Additionally, even claims subject to consolidation should be consolidated only to the extent practicable. Thus, if consolidation would unreasonably delay a decision on the current claim, consolidation is not required.
6. Subsequent non-qualifying claim pending - class claim is a redetermination claim
Do not consolidate redetermination claims with pending claims.
7. Lost folders
Send alert-query package to servicing FO via an SSA-559 annotated “Hyatt case - Lost folder. Reconstruct application (date of application to be reconstructed) per DI 12548.010B.2 and forward to DDS or OHA for readjudication” .
8. Pending class claim-readjudication claims
A readjudication claim is a class claim of an individual determined to be a Primary Subclass member or Settlement Subclass member entitled to a reopening. If judicial or administrative review of the class claim at any level has been requested or would have been timely if requested as of as of May 21, 1994, process the class claim to the extent practicable, on a priority basis in accordance with the following schedule:
Pending claims for which an ALJ hearing has been requested but not yet scheduled and which were consolidated with readjudication claims and remanded to the DDS and any ALJ appeals from the decision upon remand shall receive first priority.
Class claims remanded to the Agency from a Federal court shall receive second priority.
Class claims pending at the Appeals Council receive third priority.
Class claims pending at the administrative law judge level receive fourth priority.
Ensure that a “Priority Flag for Pending Hyatt Class Claims” (DI 42548.095, Exhibit 8) is attached to the front of all pending class claims. Remember that the flag must indicate the priority that the case must receive, i.e., 10/21/99 order, first, second, third, or fourth.