Field office (FO) technicians will use the instructions in this section to send a Title XVI or concurrent (Title II/Title XVI) common issue non-medical hearing request to the hearings level using the ENM application.
Technicians will create, upload documents, edit, and change the case jurisdiction in the ENM application, and route all Title XVI or concurrent (Title II/Title XVI) non-medical appeals cases to the Special Review Cadre (SRC), office code 5ZU, except for class action cases. Class action cases will continue to be routed to the local jurisdictional hearing office. For instructions on ENM case creation, upload instructions, and troubleshooting, see GN 03103.080B.
Once created, ENM is the official folder of record for non-medical cases.
The terms “hearing request” and “HA-501” are used interchangeably throughout these instructions. These instructions presume:
•
The beneficiary or recipient received a reconsideration determination, if procedurally applicable. For more information on the hearing process, see SI
04030.020;
•
There is a completed HA-501 (Request for Hearing by Administrative Law Judge) or i501, or a written document that disagrees with the prior determination. For more information on completing the HA-501, see GN 03103.020. For more information on iAppeals non-medical, see SI 04005.040; and
•
When applicable, there is a completed Electronic Non-disability Summary Sheet (eNDSS). For instructions on completing the eNDSS, see GN 03103.130B.
Other Program Operations Manual System (POMS) sections include instructions for processing hearing requests on the following situation:
2.
Title II
only -
non-medical
Process non-medical hearing requests for Title II only per GN 03103.080.
3.
Medicare
Part A (Hospital Insurance (HI)), Part B (Supplementary Medical Insurance (SMI)), and Income-Related
Monthly Adjustment Amount (IRMAA)
•
Process hearing requests for Medicare Part A and Part B per GN 03108.210.
4.
Representative payee misuse
Process hearing requests for payee misuse per the instructions in GN 00604.064G.
5.
No
reconsideration determination
If the claimant insists on filing a hearing request before receipt of a reconsideration determination, process the hearing request per SI 04030.020B.4.
6.
Late hearing request
When a claimant submits a hearing request late, see GN 03101.020D. Do not delay forwarding a late hearing request to the hearings level while awaiting receipt of a good cause statement.