Social Security

This Emergency Message (EM) provides information regarding 198 court-remanded cases for individuals whose cases had been redetermined under sections 205(u) and 1631(e)(7) of the Social Security Act (Act) because the Office of Inspector General (OIG) had reason to believe that fraud was involved in their applications, and in the provision of evidence in their cases.

B. Background

EM-15020 SEN REV 8 informs you of the OIG’s referral of fraud cases involving the attorney representative Eric C. Conn. We redetermined these individuals entitlement to Title II and/or Title XVI benefits under sections 205(u) and 1631(e)(7) of the Act.

On November 28, 2018, the Unites States Court of Appeals for the Sixth Circuit concluded in Hicks v. Commissioner of Social Security that our current redetermination process violated constitutional and statutory protections for individuals who challenged the agency’s redetermination process. Pursuant to the Sixth Circuit’s decision in Hicks, the courts are remanding affected cases to the agency to provide new hearings and decisions. The courts have also ordered us to reinstate benefits pending the outcome of the new redetermination proceedings. We refer to this sub-set of individuals as Hicks cases.

C. How to identify the beneficiaries, auxiliaries, and recipients in these cases

Individuals who had their cases remanded from Federal court for new proceedings will receive a letter from the Appeals Council. The letter will address their new hearing to consider their medical condition. If the individual does not know if he or she had a case pending in Federal court, or if his or her case was remanded, the individual should contact his or her attorney.

Affected individuals will also receive separate notices, which will be available in the Online Retrieval System (ORS), explaining how we will comply with the district court’s order to reinstate benefits until we make a new decision and how we will schedule a phone appointment.

D. Procedure for handling inquires for beneficiaries, auxiliaries, and recipients
If you receive questions regarding the reinstatement process for this situation, instruct them to contact the SSA employee and phone number provided in the notice.

Direct all program-related and technical questions to your Regional Office (RO) support staff. RO support staff may refer questions or problems to their Central Office contact.

References:

EM-15020 SEN REV 8 Important Information Regarding Fraud or Similar Fault Redeterminations (Huntington WV Office of Disability Adjudication and Review) (ODAR)) – One-Time Only Instructions