A confined beneficiary (or recipient), i.e., incarcerated or institutionalized, has
a right to a disability hearing. Once the individual has appealed the initial continuing
disability review (CDR) determination, the DHO must make every reasonable effort to
schedule a hearing, hear the case, and make a determination. Do not delay scheduling
a hearing until after the confined beneficiary (or recipient) is released, and do
not return the file to the FO because benefits are in suspense.
The right to a hearing also applies to appeals of Age 18 Redeterminations. Age 18
Redeterminations follow the appeal procedures for CDRs. FO policies in DI
13005.020E apply only if the initial CDR or Age 18 Redetermination has not been made and do not apply at the appeal level.
NOTE: Incarcerated or otherwise confined beneficiaries (or recipients) may be awaiting
arraignment or trial, and there is no conviction yet. They may have other circumstances
as the cause of their confinement, such as undergoing treatment in a highly structured
setting for mental disorders or substance use disorders.
1. Confirming available means for conducting the hearing for confined individuals
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a.
The DHU must contact the confinement facility officials and confirm whether:
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•
An in person hearing is permitted on the facility property;
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•
VTC equipment is available for use to conduct a VTC hearing at the facility; OR
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•
A phone is available for use by the confined beneficiary (or recipient) for a hearing
by phone.
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b.
Document the folder with all attempts to determine the possibility of a hearing for
a confined beneficiary (or recipient).
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c.
If the beneficiary (or recipient) has an appointed representative, verify whether
an appointed representative is available to proceed with the disability hearing. Refer
to DI
31001.001 for more information on representatives.
NOTE: A hearing is not necessary if the DHO can make a fully favorable determination with
evidence in file or if the beneficiary (or recipient) has waived the right to a hearing
as in DI
33015.021.
2. Deciding the means of appearance for a confined individual
Once the DHU confirms the means available for conducting the hearing, the DHO will
decide and schedule the manner of appearance using guidance in DI 33010.005B. Although the preferred manners for conducting hearings are in person or by VTC, the
DHO may schedule an individual to appear by phone when the individual’s confinement
prevents them from appearing in person or by VTC. See DI
33025.085.
NOTE: A person who is confined may have one or more special handling considerations. Confinement
alone does not constitute a special handling situation. If special handling considerations are present,
follow guidance in DI
33015.021B.
3. No possibility of a hearing for a confined individual
When the confined individual does not have an appointed representative, the evidence
in the file is insufficient to make a determination, and the DHO has made every reasonable
effort, but cannot schedule a disability hearing, the DHO will:
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a.
Document attempts to schedule the hearing in the file,
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b.
Prepare a curtailed determination to continue the period of disability,
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c.
Enter "Prisoner Case- Resolution of continuing disability issue required upon reinstatement
of benefits." in item 24 of the SSA-832 Cessation or Continuance of Disability or
Blindness Determination an Transmittal—Title XVI or SSA-833 Cessation or Continuance
of Disability or Blindness Determination an Transmittal—Title II, AND
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d.
Route the claim to the servicing FO at closure.
NOTE: This instruction also applies when there is no possibility of a hearing for a confined
individual that has an appointed representative but the appointed representative is
unable to proceed with the disability hearing. Document attempts to proceed with the
appointed representative in the file.