TN 1 (05-05)
DI 80550.030 Establishing a Hearing Case
A hearing may be initiated by:
Submission of a hearing request form or letter to an SSA field office (FO) or HO;
Reopening of an Administrative Law Judge (ALJ) decision; or
An Appeals Council Order remanding a case to an ALJ.
The way a hearing is initiated determines how you must establish the case. A HO user will be unable to view or edit case information until case establishment occurs.
The HO user must establish the case in CPMS to:
Set up control and receive the case into the Master Docket;
Enter receipt of claim file;
Enter new or revised case information, such as claimant and representative addresses and other case characteristics;
Enter case characteristics; and,
Enter case assignment to an ALJ.
Because much of the data determines subsequent case disposition and routing, it is essential that the data are entered accurately. Incorrect entries can result in misrouted cases and delayed payment to claimants.
A. Request for Hearing Filed at FO
When any FO receives a Request for Hearing, the hearing information is generally input into the Modernized Claims System (MCS) or Modernized Supplemental Security Income Claims System (MSSICS). FO processing of the Request for Hearing generates a CPMS Workload Listing item to alert the owning HO that an appeal has been filed.
B. Request For Hearing Filed at HO
If a HO receives a direct Request for Hearing, the HO must:
Date stamp the document to acknowledge receipt;
Fax or mail a copy of the Request for Hearing to the servicing FO for input into MCS/MSSICS; and
Establish the case in CPMS through SSN or name Search.
C. Establishing a Case in CPMS
Once you have entered all necessary data, selecting [Save and Establish Case] completes and closes the establish function.
1. Establishing a Case through Workload Listing
Workload control provides a listing of cases that need to be established in CPMS. However, CPMS does not provide cross reference to other pending cases. Therefore, establish the case after a SSN search whenever possible. The SSN search provides a list of all pending cases that meet your search criteria, whether the originating source is CPMS, MCS, or MSSICS.
If a case has not been established in CPMS, but is established in MCS/MSSICS, the SSN Search results are displayed with the [Add This Case] link. The [Case Source] field describes data origination as MCS, MSSICS, or MCS MSSICS. You can establish a case by selecting the [Add This Case] link. This function allows you to add a specific case to CPMS, with information propagated to the appropriate fields. Verify all propagated data and add missing information manually; incorrect data can result in misrouted cases and delayed processing.
NOTE: A concurrent case (i.e. DIWC and SSID) originating from both MCS and MSSICS is displayed on two separate workload control listings if the request for hearing date is different. You will need to establish a concurrent case from one of the listings. The other listing will remain as a result in a SSN search until its deletion, 45 days after its establishment in MCS or MSSICS.
2. Establishing a Case through SSN or Name Search
a. Establishing an existing MCS or MSSICS case
A SSN or name search, as described in DI 80550.020 (CPMS Case Search) above, will display matching results. A case already established in MCS/MSSICS is displayed with the [Add This Case] link, and the [Case Source] field shows the data origination as MCS or MSSICS. A case originating from both MCS and MSSICS may be displayed twice if the Request for Hearing date is different. You must establish only one concurrent case.
Establish a case in CPMS by selecting the [Add This Case] link. MCS/MSSICS information automatically propagates to the appropriate fields. After selecting [Add This Case], CPMS displays the Case Information screen for case establishment with the propagated case information. Verify all propagated information and manually enter missing information.
b. Manually Establishing a Case in CPMS
If a SSN or name search, as described in DI 80550.020 (CPMS Case Search) above, displays “No records found that match the search criteria,” you cannot establish the case with propagated information. If you have a request for hearing, transmit that request to the FO for entry into MSC/MSSICS, following the regular business process. If you have a MCS/MSSICS exclusion or a case initiated by reopening of a decision or Appeals Council Remand Order, you must key the data for these cases manually into CPMS. Select the [Add A Case] link. CPMS displays the Case Information screen for case establishment. Enter all information manually.
3. Electronic Folder (EF) Cases
All cases being worked as an electronic case are identified through the case characteristic code of EFGN (case is being processed electronically). The EF Management Information (MI) reports are now generated through the use of the case characteristic field. Therefore, each office must verify that the pending number of EF cases is correct.
Use the following guidelines for EF cases:
Establish the case characteristic when your office will process the case electronically;
Close the case characteristic when you are no longer processing case electronically, or when you transfer the case to another office; and
When you receive a transferred case, check the case characteristic. If your office is not working the case as an EF, close the case characteristic.