TN 11 (03-24)

SI 04030.040 While the Supplemental Security Income (SSI) Hearing Is Pending

A. Policy

1. Remand for Revised Determination

a. When a Case May be Remanded

An administrative law judge (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 them that the case has been remanded to another component for further evaluation and that unless they object within 10 days of the remand we shall assume that they have 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 Disability Determination Services (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, they may ask the Regional Chief ALJ (RCALJ) for that region to take the witness' deposition.  Furnish the RCALJ any aid their requests.

b. Development

If the ALJ wants further development in another region, they will send a memorandum to the appropriate field office (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 03103.010B.4 on completing the SSA-3441 if an HA-501 and new information are 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 their present condition, accept it and attach it to the HA-501.

2. Appellant Changes Address

If you receive notice that the appellant has changed their address, advise the hearing office (HO) to which the SSA-636 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 Supplemental Security Record (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 their 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 Office of Hearings Operations (OHO) Headquarters, forward subsequent correspondence to OHO Headquarters, rather than to the ALJ.

Correspondence and materials should be uploaded in eView or Electronic Non-Medical (ENM), as appropriate. If there is no electronic record, post-decisional materials should be emailed to the Office of Appellate Operations (OAO) at ^DCARO OAO and FO should query the current location of the paper claims folders, and route any paper materials to that location for association.

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

Advise the member of Congress that their request has been forwarded to the ALJ. In forwarding the correspondence to the ALJ, call their 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 OHO, after the FO becomes aware of the affirmation.

  • Ensure that all material includes the appellant's name and Social Security Number (SSN).

  • Upload materials in eView or ENM, as appropriate.

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 a Report of Contact (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 their interests if their rights might be adversely affected. Also, a person may be called as a witness because they have 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 HO.

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 them, the ALJ.

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, they may contact the servicing FO for assistance in securing the folder. Follow the procedure set out in SI 04030.030C 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 their 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 HA-501. Complete and distribute copies of the HA-501 immediately in accordance with GN 03103.020 and SI 04030.030.

b. The Appellant Wishes to Submit Evidence But Does Not Have It with Them

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

  • Note on the HA-501 if they have evidence with them but refuses to submit it to the FO.

  • Distribute the HA-501 immediately.

  • If the claimant submits the evidence to the FO rather than the HO, forward it immediately to the HO per SI 04030.030 and DI 12010.010, as appropriate.

c. The Appellant Promises to Submit Evidence:

  • If the evidence is received in the FO, forward it directly to the ALJ per SI 04030.030 and DI 12010.010, as appropriate.

  • If the appellant requests assistance, make all reasonable efforts to assist them with 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 non-disability eligibility factors per SI 00603.015. If this information cannot be obtained when the request for hearing is received, distribute the HA-501 immediately and forward the information as soon as possible directly to the HO per DI 12010.010.

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.

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SI 04030.040 - While the Supplemental Security Income (SSI) Hearing Is Pending - 03/13/2024
Batch run: 03/13/2024