TN 1 (12-00)

SI 04030.040 While the SSI Hearing Is Pending

A. Policy

1. Remand for Revised Determination

a. When a Case May be Remanded

An ALJ may remand a case to the appropriate component if there is reason to believe that the revised determination would be fully favorable to the appellant. This may occur if the ALJ receives new and material evidence or there is a change in the law that permits a favorable determination.

b. Notice of Remand

Unless the appellant requests the remand, the ALJ shall notify him/her that the case has been remanded to another component for further evaluation and that unless he/she objects within 10 days of the remand we shall assume that he/she has agreed to the remand.

c. Objections to a Remand

If the appellant objects, the ALJ will consider the objections and rule on them in writing.

d. Informal Remand in Cases of Mental Disorders

If new evidence is received that is not cumulative of evidence contained in the file, or if the issue of mental impairment arises for the first time at the hearing level, the ALJ may remand to the DDS for a new determination.

NOTE: A case may also be remanded if the ALJ needs the services of a medical expert but none is available.

2. Interregional Assistance

a. Testimony

If the ALJ wants to get testimony from a witness who lives in another region, he/she may ask the Regional Chief ALJ (RCALJ) for that region to take the witness' deposition.  Furnish the RCALJ any aid he/she requests.

b. Development

If the ALJ wants further development in another region, he/she will send a memorandum to the appropriate FO in that region. If you receive such a request, take prompt action to obtain the requested information. Send the requested evidence or information directly to the ALJ.

B. Procedure

1. Receipt of Current Information on a Disability Case

  • See GN 03103.010C.2 on completing the SSA-3441 if an HA-501-U5 and/or new information is received in the mail and the issue is the nature and severity of the appellant’s disability.

  • Do not develop any of the leads which the information you receive may suggest. If the appellant has any evidence on his/her present condition, accept it and attach it to the claims file copy of the HA-501-U5.

2. Appellant Changes Address

If you receive notice that the appellant has changed his/her address, advise the HO to which the SSA-636-U3 was sent. If the notice comes from someone other than the appellant, verify it with the appellant, unless it is received from a representative payee, legal guardian or parent of the appellant. Annotate the notice “Hearing Office notified,” and update the case control system and the SSR to reflect the new location of the folder, if necessary.

3. Correspondence Concerning a Pending Hearing Case

a. Status Requests

Send all correspondence regarding the status of the request to the ALJ for reply. Always acknowledge the inquiry and inform the inquirer of the referral. Acknowledge congressional correspondence by letter.  Acknowledge inquiries from other sources by letter or telephone, as appropriate.

b. Correspondence Other Than Status Request

Refer to the ALJ any correspondence you receive about the issue before the ALJ or about his/her decision.

When you are aware (either by receipt of a copy of the ALJ's decision or order, or a copy of Form HA-5051-U3 (Transmittal of Decision on Disability)) that the ALJ has sent a claims file to ODAR Headquarters, forward subsequent correspondence to ODAR Headquarters, rather than to the ALJ.

c. Congressional Request to be Advised of ALJ's Decision

Advise the member of Congress that his/her request has been forwarded to the ALJ. In forwarding the correspondence to the ALJ, call his/her attention to the congressional request.

4. Material Concerning a Pending Hearing Case

  • Obtain the Summary Query Screen (SUMM) from the OHAQ to determine the location of the folder.

  • Forward any such material received after a case has been transmitted to the location identified by the query if it relates to the hearing.

  • Hold other material in the FO until the case folder is returned. However, in affirmation decisions, since the folder will not be returned to the FO for effectuating except in medical/blindness cessation affirmation, forward any other material to ODAR Headquarters, 5107 Leesburg Pike, Falls Church, Virginia 22041-3255, after the FO becomes aware of the affirmation.

  • Ensure that all material includes the appellant's name and SSN.

5. ALJ Requests For Development

a. Handle the Request Promptly

Respond to the request as quickly as possible because the regulations require the ALJ to issue a decision within 90 days after the hearing is requested.

NOTE: Disability cases are exempt from this requirement but still require the fastest possible handling.

b. If the Appellant Must be Contacted

Explain that the request for this evidence or information is made at the request of the ALJ. If the appellant objects or refuses to cooperate, return the request to the ALJ with an RC explaining why the development was not completed.

c. Asking a Person to Appear

If the ALJ asks you to notify the appellant to appear, contact the person as quickly as possible. If you cannot contact the person or the person refuses to appear, notify the ALJ and explain in detail in an RC the efforts made.

NOTE: The ALJ may notify a recipient or other person who did not request a hearing to appear at the hearing to protect his/her interests if his/her rights might be adversely affected. Also, a person may be called as a witness because he/she has material evidence which the ALJ needs to arrive at a decision.

NOTE: See GN 03103.160B.4. if the ALJ requests an FO employee to appear as a witness.

d. Contacts With a Person Other Than the Appellant

Make every reasonable effort to secure the evidence or information. If the evidence or information cannot be secured, promptly return the request to the ALJ and explain in detail on an RC the efforts made and the reason why the evidence or information could not be obtained. Have all evidence or information forwarded directly to the hearing office

e. Advising the ALJ of the Status of Development Requests

If an ALJ's development request is pending in the FO for 20 days (45 days for disability issues) and the ALJ has not requested that the development or status information be forwarded sooner, advise the ALJ of the present status and ask whether development should be continued.

NOTE: The ALJ may be able to get the evidence or information by scheduling a hearing and having the parties appear before him/her.

Follow the ALJ's direction as to continuing the development, but do not keep a request for development pending indefinitely. Whenever it appears that further efforts will be unproductive return the request to the ALJ with a full explanation and any material received.

6. ALJ Requests Additional Folders

If the ALJ determines that another folder, in addition to those previously furnished, is needed, he/she may contact the servicing FO for assistance in securing the folder. Follow the same procedure set out in SI 04030.030B. to secure the folder for the ALJ.

7. FO Assistance in Hearing Interviews

If the ALJ requests assistance from the FO, bring the application information up to date, by obtaining the appellant's statement regarding his/her current income, resources, living arrangements, etc. However, do not develop any leads suggested by the information obtained unless requested to do so by the ALJ.

a. The Appellant Submits Evidence

Attach it to the claims file copy of the HA-501-U5. Complete and distribute copies of the HA-501-U5 immediately in accordance with GN 03103.020 and GN 03103.080.

b. The Appellant Wishes to Submit Evidence But Does Not Have It with Him/ Her

  • Indicate on the HA-501-U5 the nature of the evidence and the date he/she will submit it. Provide the claimant with a self-addressed envelope to the hearing office and request that it be submitted within 10 days. If it cannot be submitted within 10 days, ask the claimant for the date he will submit it. Include this information on the HA-501-U5 and the online appeal screen AMAD (More Appeal Data.)

  • Note all copies of the HA-501-U5 if he/she has evidence with him/ her but refuses to submit it to the FO.

  • Distribute all copies of the HA-501-U5 immediately.

  • If the claimant submits the evidence to the FO rather than the hearing office, forward it immediately to the HO by route slip.

c. The Appellant Promises to Submit Evidence:

  • If the evidence is received in the FO, forward it directly to the ALJ by route slip.

  • If the appellant requests assistance, make all reasonable efforts to assist him/her in obtaining the evidence. Notify the HO by RC of the reason the evidence could not be obtained if all efforts are unsuccessful.

d. Disability/Blindness Cases

If the disability claim was denied for medical reasons, review the nondisability eligibility factors per SI 00603.015. If this information cannot be obtained when the request for hearing is received, distribute all copies of the HA-501-U5 immediately and forward the information as soon as possible directly to the HO by a route slip.

If disability benefits were denied for failure to cooperate and the appellant now submits evidence that makes a favorable DDS action likely, consider initiating the informal remand procedures.


To Link to this section - Use this URL:
http://policy.ssa.gov/poms.nsf/lnx/0504030040
SI 04030.040 - While the SSI Hearing Is Pending - 11/28/2014
Batch run: 11/28/2014
Rev:11/28/2014