ISSUED: May 26, 1995
I. Purpose
This Temporary Instruction (TI) incorporates into HALLEX longstanding Regional Chief Administrative
Law Judge (ALJ) instructions for implementing two related court
orders: Sharpe v. Sullivan, 79 Civ. 1977 (CHS)
(S.D.N.Y. Mar. 6, 1990) and Martinez v. Bowen,
73 C 900 (E.D.N.Y. Apr. 24, 1986).
II. Background
On July 10, 1980, the U.S. District Court for the Southern District of
New York entered an Amended Order and Final Judgment setting forth certain
notice and processing time requirements for Supplemental Security Income
(SSI) claims by New York State residents who request ALJ hearings. That
order also required payment of interim benefits in certain cases when
the court-ordered processing time deadlines were not met.
On March 6, 1990, the court entered a Second Amended Order and Final
Judgment which amended certain aspects of the July 10, 1980 order. OHA
implemented the March 6, 1990 order in memoranda dated August 17, 22,
27 and 30 and November 9, 1990, from the Regional Chief ALJ for Region II.
In 1978, the U.S. District Court for the Eastern District of New
York issued orders prescribing time limits for holding hearings in title
II disability claims by New York State residents. The orders mandated
the payment of interim benefits if the time limits were not met and
established requirements for monitoring compliance. On May 28, 1985,
the court vacated its previous orders granting class-wide relief, but
indicated that it intended to order alternate class-wide relief in the
form of a notice. On April 24, 1986, the court ordered the Secretary
to send a specific notice to all class members at the same time OHA
acknowledges receipt of a claimant's request for hearing. On June 10,
1986, the Regional Chief ALJ for Region II issued a memorandum directing
all New York hearing offices (HOs) to implement the court's order.
III. Class Definitions
The Sharpe class includes all claimants who:
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reside in New York State,
•
have received adverse determinations on their claims,
•
have filed requests for hearing, and
•
are awaiting either the holding of their hearings,
the issuance of decisions, or effectuation of favorable decisions.
A person is not a
Sharpe class member if
(1)
(1) he or she is a Martinez
class member by virtue of a concurrent claim for disability benefits
under titles II and XVI; or
(2)
(2) he or she has been verified with the New York
State Department of Social Services, or the appropriate local agency,
to be receiving Interim Assistance benefits from the State of New
York.
In New York State, the Interim Assistance
benefit consists solely of home relief public assistance
benefits; it does not include public assistance from Aid to
Families with Dependant Children (AFDC). The HO may identify claimants
as Interim Assistance recipients through evidence or statements already
in file, hearing testimony or through an SSI2 query requesting the
MPMT (miscellaneous payment data segment). An entry of GRC (grant
reimbursement and state and county code) in the MPMT segment followed
by a five-digit code beginning with 33 indicates receipt of Interim
Assistance from New York State. (Program Operations Manual System (POMS)
chapter SI 02003.000 provides
more details on Interim Assistance Reimbursements.)
Because Interim Assistance recipients are not
Sharpe class members, it is not necessary to send
them any of the court ordered notices and they are not subject to the
interim benefit procedures in Part VI. A. below.
The Martinez class includes all claimants who:
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have filed for disability benefits under title II of the Social Security Act (this includes concurrent claims under titles II and XVI),
•
reside in New York State,
•
have filed requests for hearing, and
•
are awaiting either the holding of their hearings or
the issuance of their decisions.
IV. Processing Time Requirements
The Sharpe order requires the Secretary
to issue decisions to class members within 90 days for non-disability issue cases and “within
a reasonable time” for disability issue cases. The order
specifies certain extensions and exceptions to the 90-day time limit
for non-disability issue cases as described below.
1. Pre-hearing Extensions
a. Claimant Unavailable for Hearing
If the claimant or representative reports that either is not
available on the date for which a hearing is scheduled, the H0 must
reschedule the hearing for a date within 45 days after the ALJ is
informed that the claimant or the representative (if there is one)
becomes available for a hearing. If no hearings are scheduled to be
held in the area of the claimant's residence within the 45-day period,
the HO will reschedule the hearing for the next hearing trip the ALJ
makes to the area of the claimant's residence. However, if the claimant
is willing to travel to the HO, the HO must schedule the hearing within
the 45-day time limit. In the event of a claimant-requested postponement
under this provision, the time limit for issuing a decision is extended
by the length of time between the date that the hearing was originally
scheduled and the date for which the hearing is rescheduled.
b. Request for Additional Evidence before a Hearing Is Held
If the ALJ requests additional evidence before the hearing, he or
she must do so within 45 days after the request for hearing is filed. The
ALJ must hold a hearing within 30 days after receiving the additional
evidence. In the event of a pre-hearing request for evidence under this
provision, the time limit for issuing a decision is extended by the
length of time between the date that the ALJ requests the additional
evidence and the date such evidence is received.
c. Claimant Requests Additional Time before a Hearing Is Held
If the claimant requests additional time to submit more evidence,
or to obtain witnesses or representation, the time period for issuing
a decision is extended by a period not to exceed the additional time
granted.
d. Uncontrollable Circumstances
If the ALJ cannot hold the hearing within the timeframes specified
above because of uncontrollable circumstances, e.g., natural catastrophe
or the unexpected illness of the ALJ, the ALJ may ask the Regional Chief
ALJ for an extension of time of up to 30 days. Excessive workload cannot
constitute an uncontrollable circumstance. In the event that such an
extension is granted, the time limit for issuing a decision is extended
by the length of the extension granted.
2. Post-hearing Extensions: Uncontrollable Circumstances
If the ALJ cannot issue a decision within the time required by the
court because of uncontrollable circumstances, e.g., natural catastrophe
or the unexpected illness of the ALJ, the ALJ may ask the Regional Chief
ALJ for an extension of time of up to 30 days. Excessive workload cannot
constitute an uncontrollable circumstance. In the event that such an
extension is granted, the time limit for issuing a decision is extended
by the length of the extension granted. If the Regional Chief ALJ denies
the request for extension, the ALJ must issue the decision within 5
working days following the denial of the request for extension.
3. Exceptions to Processing Time Requirements
If the ALJ requests additional evidence after the hearing, he or
she must request it within 30 days after the hearing is held. The ALJ
must issue the decision within 30 days after the additional evidence
is received and the period for comment has ended (see b. below if a
supplemental hearing is needed).
If the claimant wishes to submit additional evidence or written
statements of fact and law, the ALJ must issue the decision within 30
days of receiving the additional evidence.
If, on the basis of additional evidence, the ALJ decides that a
supplemental hearing is necessary, the ALJ must hold the hearing within
30 days of receiving the additional evidence, and must issue a decision
within 30 days after holding the supplemental hearing.
If, after a hearing has been held, it is necessary to reassign
a case to another ALJ because the original ALJ is unavailable,
e.g., through resignation, retirement or illness, the Hearing
Office Chief ALJ must reassign the case within 30 days of the date
the Regional Chief ALJ learns of the unavailability. The new ALJ
must issue a decision within 30 days of the reassignment unless
another extension or exception applies, e.g., a new hearing may be
required (see HALLEX HA 01280.040).
The 1985 and 1986 Martinez orders eliminated
all specific processing time deadlines for Martinez
class members. However, Martinez class members
may seek judicial relief if they believe their claims are being
“unreasonably delayed.” The court ordered acknowledgment
notice that the HOs must send to all class members describes how claimants
can determine the status of their claims and the procedures available
if they believe there has been an unreasonable delay (see Part V. B. below).
V. Notice Requirements
1.
In all title XVI disability
issue class member cases in which a hearing has not been held
or a decision rendered within 120 days after the date the claimant
files a request for hearing, the HO must send the individualized
notice contained in Exhibit A of the
court's order (see Attachment 1) to the claimant, with a copy to the
claimant's representative, if any. The HO must also send copies of
all Exhibit A notices to counsel for the Sharpe
class at the address shown on that attachment. The notice must contain
an individualized explanation of why SSA has not yet held a hearing
or issued a decision. To the extent applicable, the individualized
explanation should indicate which of the extensions or exceptions listed
in Part IV. A. above apply. The notice
must contain the address(es) of the appropriate U.S. District Court and
the pro se clerk's telephone number, which can be determined from the
list in Attachment 2. The HO must mail the Exhibit
A notice 120 days after the request for hearing is filed or within 10
days thereafter.
The 10-day period for mailing the Exhibit
A notices cannot be extended (i.e, the exceptions and extensions in
Part IV. A. above do not apply to the
mailing of notices.)
2.
In all title XVI non-disability
issue class member cases in which a hearing has not
been held or a decision rendered within 90 days after the date
the claimant files a request for hearing, and the Secretary will
not be paying interim benefits as
explained in Part VI. A. below,
the HO must send the individualized notice contained in Exhibit B of the court's order (see Attachment
3) to the claimant, with a copy to the claimant's representative, if
any. The HO must also send copies of all Exhibit B notices to counsel
for the Sharpe class at the address shown on that
exhibit. The notice must contain an individualized explanation of why
SSA has not yet held a hearing or issued a decision. The individualized
explanation should indicate which of the extensions or exceptions listed
in Part IV. A. above apply. (If none
applies, the Exhibit B notice is inappropriate and the HO must initiate
interim benefits — see Part VI. A.
below.) The notice must contain the address(es) of the appropriate
U.S. District Court and the pro se clerk's telephone number, which can
be determined from the list in Attachment 2. The
HO must mail the Exhibit B notice 90 days after the request for hearing
is filed or within 10 days thereafter.
The 10-day period for mailing the Exhibit
B notices cannot be extended (i.e., the exceptions and extensions in
Part IV. A. above do not apply to the
mailing of notices.)
3.
In all title XVI non-disability
issue class member cases in which the Secretary will be paying interim benefits as explained in
Part VI. A. below, the HO must send
the notice contained in Exhibit C
of the court's order (see Attachment 4) to the claimant, with a
copy to the claimant's representative, if any. (Although the notice
contains the Social Security field office address, the HO will prepare
and release it.) This notice advises the claimant that he or she will
receive prospective interim benefits until a decision is issued. The HO
must mail the Exhibit C notice 90 days after the request for hearing
is filed or within 10 days thereafter.
4.
In all title XVI class member cases, both
disability and non-disability issue cases, in which an ALJ
issues a fully or partially favorable
decision, the HO must send the claimant the notice contained in
Exhibit D of the court's order (see
Attachment 5) with the claimant's copy of the decision. The HO must
also send a copy to the claimant's representative, if any, and to the
Sharpe class counsel.
In Exhibit D, the HO must indicate the appropriate time limits which
apply to calculation and payment of SSI payment amounts. If the ALJ's
decision does not address all elements of SSI eligibility (e.g., income,
resources,and residency) for the entire
period on which the ALJ rules favorably, the Exhibit D notice must
reflect a 60-day time limit for calculation of benefit amounts and a
75-day time limit for payment of benefits. If the ALJ's decision does
address all elements of SSI eligibility for the entire period on which
the ALJ rules favorably, the time limits are 20 days for calculation of
benefits and 35 days for payment.
In all title II and title II/title XVI concurrent disability
claims, the HO must advise the claimant, and representative, if any,
of the claimant's right to petition the district court for relief,
including interim benefits, if he or she believes his or her case is being
unreasonably delayed. The HO must do this at the time it acknowledges
receipt of the claimant's request for hearing, either by including the
Attachment 6 language in the acknowledgment notice, or by including a
separate notice containing Attachment 6 language with the acknowledgement
letter when it is sent.
VI. Interim Benefit Requirements
The Sharpe order requires the
Secretary to pay interim benefits in all title XVI non-disability class member cases in which a
decision has not been issued within 90 days after the date the claimant
files a request for hearing, subject to any of the time extensions
or exceptions listed in Part IV. A.
above. If the 90 days expire on or before the fifteenth day of the month,
entitlement to interim benefits is effective as of the first day of that
month. If the 90 days expire after the fifteenth of the month, entitlement
is effective as of the first day of the following month.
The HO must monitor Sharpe cases to ensure
that the HO timely requests payment of benefits when appropriate. The HO
must initiate interim benefits within the same 90 to 100-day timeframe
for mailing the Exhibit C notice (Attachment 4) as described in Part V. A. 3. above.
To initiate interim benefits, the HO must send a memorandum, via
E-Mail, to the Regional Chief ALJ, Region II, with a copy to the Regional
Commissioner. The Regional Commissioner's E-Mail address is:
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¦¦NY ARC POS RSI/SSI BRANCH |
The memorandum should contain the following information:
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Subject: Sharpe Case Requiring Interim Benefits |
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Claimant:
>
Social Security Number:
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ALJ Name and Code:
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DO Code:
>
Start Date:
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If the claimant is already in payment status, do not
initiate interim benefits. Instead, send the claimant an Exhibit B
notice explaining the reason(s) for the delay and advising that no
interim benefits are payable because he or she is already receiving
benefits.
When the ALJ issues a decision, send another E-Mail memorandum
to the Regional Chief ALJ, with a copy to the Regional Commissioner,
repeating the above information and indicating the following:
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Stop Date: |
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Date of Decision: |
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Type of Decision: |
No interim benefits are payable before the issuance of an ALJ decision in
disability issue cases.
The Sharpe order provides that the Secretary
must pay interim benefits after a
favorable ALJ decision is issued, for both disability and non-disability
issue claims, if effectuation of benefits is not made within the time
limits spelled out in the order. SSA field offices initiate these
payments through the Regional Commissioner's Office and advise the
claimant using the notice contained in Exhibit E of the court's order
(Attachment 7).
OHA's only involvement is to send the Exhibit D notice discussed
above, advising the claimant of the applicable timeframes.
The Martinez order currently in effect
contains no interim benefit requirements.
VII. Reporting Requirements
The Sharpe order requires the Secretary to
submit certain processing time reports on a quarterly basis. All HOs
handling claims from residents of New York State must use the Hearing
Office Tracking System (HOTS) program furnished by the Regional Office to
identify Sharpe cases and to gather the required
statistics. The HOs must submit quarterly reports to the Regional Office
by the third Friday following the end of each calendar quarter.
The Martinez order currently in effect contains no
reporting requirements.
VIII. Inquiries
HO personnel should direct any questions to their Regional
Office. Regional Office personnel should contact the Division of Field
Practices and Procedures in the Office of the Chief Administrative Law
Judge at (703) 305-0022. Headquarters personnel should contact the
Division of Litigation Analysis and Implementation in the Office of
Policy, Planning and Evaluation at 305-0724.
Attachment 1. Exhibit A: Personalized 120-day Notice for Sharpe Disability
Class Members
Claimant's Name
Address
City,
State, Zip
Dear _______________:
You requested a hearing before an Administrative Law Judge on
[Insert request for hearing date.],
over 120 days ago. We have not yet
[scheduled your hearing/issued a decision after your hearing]
because
[Insert detailed reason(s).].
If you want more information concerning the status of your case or if you
want us to act more quickly on your case, you may call or write to us at
the above phone number and address. Ask to speak to a
[hearing assistant/hearing clerk].
Your hearing is about whether you are disabled, and you have the right to
a hearing and decision within a reasonable time after your hearing
request. You have this right because of a federal district court order in
Sharpe v. Sullivan, 79 Civ. 1977 (CSH)
(S.D.N.Y.).
The court order in Sharpe does not require us to
pay you benefits while we decide your case (“interim
benefits”). However, if you believe that there has been an
unreasonable delay in your case, you may seek help in the United States
District Court for the
[Northern/Southern/Eastern/Western]
District of New York. You may make a motion to the judge for an Order
directing us to provide your hearing and/or decision promptly and to pay
you interim benefits until we do this. The Court is located at the
following location(s):
[See Attachment 2 for a list of district court addresses and pro se clerk
telephone numbers.]
If you need help making this motion in court, there are “pro
se” clerks in the Courthouse to assist you. The “pro
se” clerk's telephone number is listed in the above
paragraph.
You may also wish to consult an attorney about your rights. Free legal
services may be available if you qualify for them due to financial
need.
A list of attorneys who may be able to provide free services is
attached.
cc: The Legal Aid Society
Civil Appeals
Law Reform Unit
Sharpe Compliance
11 Park Place
New
York, New York 10007
[Representative's
name & address]
Attachment 2. Addresses of U.S. District Courts in New York State and Pro se
Clerk Telephone Numbers
Northern District of New York
U.S. District Court (NDNY)
445 Broadway
Albany, New York
12201U.S. District Court
(NDNY)
100 South Clinton Street
Syracuse, New York
13260U.S. District Court (NDNY)
U.S. Federal Building
Binghamton,
New York 13901U.S. District Court
(NDNY)
10 Broad Street
Utica, New York 13501
Pro se Clerk's Telephone Number: (315) 793-8155
Southern District of New York
U.S. District Court (SDNY)
United States Courthouse, Annex
500
Pearl Street
New York, New York 10007
Pro se Clerk's Telephone Number: (212) 791-0165
Eastern District of New York
U.S. District Court (EDNY)
One Pierrepont Plaza, 11th
Fl.
Brooklyn, New York 11201U.S. District Court
(EDNY)
300 Rabro Drive
Hauppauge, New York 11788U.S. District Court (EDNY)
Uniondale Avenue at Hempstead
Turnpike
Uniondale,
New York 11553
Pro se Clerk's Telephone Number: (718) 330-7523
Western District of New York
U.S. District Court (WDNY)
68 Court Street
Niagara
Square
Buffalo, New York 14202U.S. District Court (WDNY)
U.S. Courthouse
100 State Street
Rochester, New York 14614
Pro se Clerk's Telephone Number: (718) 846-4211
Attachment 3. Exhibit B: Personalized 90-day Notice for
Sharpe Non-disability Class Members
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SOCIAL SECURITY ADMINISTRATION |
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_________________________________________________________________________ |
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Office of Hearings and Appeals |
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HO address and |
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telephone number |
SSN:
Claimant's Name
Address
City,
State, Zip
Dear _______________:
You requested a hearing before an Administrative Law Judge on
[Insert request for hearing date.],
over 90 days ago.
Your hearing does not involve a disability issue, and therefore you have
the right under the Social Security Act to a hearing and a decision within
90 days after your hearing request. Under a federal district court order
in Sharpe v. Sullivan, 79 Civ. 1977 (CSH)
(S.D.N.Y.), we are required to pay interim benefits to claimants to whom
we have not issued a hearing decision within 90 days after a hearing
request. However, under the order, we do not have to pay interim benefits
when certain special exceptions apply.
We believe that we are not required to pay you interim benefits at this
time because of the following special exception(s) that applies(apply) to
your case:
[Insert explanation, referring to all applicable exceptions and extensions. See Part IV. A.]
If you want more information concerning the status of your case or if you
want us to act more quickly on your case, you may call or write to us at
the above phone number and address. Ask to speak to a
[hearing assistant/hearing office clerk].
If you believe that we have unreasonably delayed your case, you have a
right to seek help in the United States District Court for the
[Northern/Southern/Eastern/Western]
District of New York. You may make a motion to a judge for an Order
directing us to provide your hearing and/or decision promptly and to pay
you benefits (“interim benefits”) while we do this. The Court
is located at the following location(s):
[See Attachment 2 for a list of district court addresses and pro se clerk
telephone numbers.]
If you need help making this motion in court, there are “pro
se” clerks in the Courthouse to assist you. The “pro
se” clerk's telephone number is listed in the above
paragraph.
You may also wish to consult an attorney about your rights. Free legal
services may be available if you qualify for them due to financial
need.
A list of attorneys who may be able to provide free services is
attached.
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Administrative Law Judge |
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Attachment |
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cc: The Legal Aid Society
Civil Appeals
Law Reform Unit
Sharpe Compliance
11 Park Place
New
York, New York 10007
[Representative's
name & address]
Attachment 4. Exhibit C: Interim Benefits Notice for
Sharpe Non-disability Class Members (to Be Sent by
HO)
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SOCIAL SECURITY ADMINISTRATION |
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_________________________________________________________________________ |
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Office of Hearings and Appeals |
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HO address and |
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telephone number |
SSN:
Claimant's Name
Address
City,
State, Zip
Dear _______________:
Because your Supplemental Security Income (SSI) case does not involve a
disability issue, the Social Security Administration is generally required
to issue a decision after hearing within 90 days after your hearing
request is filed. Because we have not decided your claim within this time
limit, we will shortly begin sending you special interim benefit payments.
These payments are required under a federal district court order in
Sharpe v. Sullivan,
79 Civ. 1977 (CSH) (S.D.N.Y.).
If you do not begin to receive your special interim benefit payments
within two weeks of the date of this letter, you may call a claims
representative at our toll free number,
1-800-772-1213. You may also call this number if you do not wish to
receive these special interim payments while awaiting a decision in your
case.
Please keep the following in mind:
1. If you receive a
favorable decision after hearing,
you will stop receiving special interim benefits and will begin receiving
your regular benefits.
If we learn that the amount of the special interim benefits we paid to you
is higher than the regular benefits you should have received for the same
time period, we will decide that you were overpaid. In that case, we will
mail you a written notice that explains how we computed the overpayment,
how we will collect the overpayment, and how you may appeal our decision
that you were overpaid. The notice will also tell you how you may request
a waiver of the overpayment. If we agree to waive the overpayment, we will
not take any steps to collect the overpaid amount from you.
If, on the other hand, we learn that the amount of the special interim
benefits we paid you is lower than the regular benefit amount you should
have received for the same time period, we will promptly pay you the
amount by which you were underpaid and send you a written notice that
explains how the underpayment was computed.
2. If you receive an unfavorable decision after hearing,
your special interim benefit payments will stop, and the special interim
benefit payments you have received will be considered an overpayment. You
will have all the rights described above, including the right to appeal
our decision and to ask us to waive recovery of the overpayment.
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Field Office Manager |
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Attachment |
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cc: The Legal Aid Society
Civil Appeals
Law Reform Unit
Sharpe Compliance
11 Park Place
New
York, New York 10007
[Representative's
name & address]
Attachment 5. Exhibit D: Notice to Accompany All Fully and Partially Favorable
ALJ Decisions in Sharpe Class Member Cases
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SOCIAL SECURITY ADMINISTRATION |
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_________________________________________________________________________ |
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Office of Hearings and Appeals |
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HO address and |
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telephone number |
SSN:
Claimant's Name
Address
City,
State, Zip
Dear _______________:
As the enclosed Administrative Law Judge hearing decision explains, we
have found that you are eligible to receive Supplemental Security Income
payments.
We will calculate your current and retroactive monthly benefit amounts
within
[60 days/20 days because we do not need more information on your financial eligibility]
and we will send you your current and retroactive benefits within
[75/35] days unless special
exceptions apply. You have the right to prompt payment of your benefits
because of a federal district court order in
Sharpe v. Sullivan, 79 Civ. 1977 (CSH) (S.D.N.Y.).
If you have any questions or need additional information, please call our
toll free number 1-800-772-1213 and ask for a claims representative.
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Administrative Law Judge |
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Attachment |
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cc: The Legal Aid Society
Civil Appeals
Law Reform Unit
Sharpe Compliance
11 Park Place
New
York, New York 10007
[Representative's
name & address]
Attachment 6. Language to Accompany or be Incorporated into Request for Hearing
Acknowledgment Notices in all Martinez Class Member
Cases
We have received your request for a hearing and we will notify you at
least 20 days before the hearing as to when and where it will be held.
Although we will make every effort to schedule you as soon as possible,
there may be a delay in scheduling your hearing. If you wish to find out
anything else about the status of your case, you may call or write to us
at the above listed address.
We are required by district court opinion, dated May 28, 1985, in
Martinez, et al. v. Secretary of HHS,
E.D.N.Y., No. 73 Civ. 900, to notify you of procedures available to you in
the event of unreasonable delay in processing your case. If, after
requesting a status report of your case, as explained above, you believe
your case is being delayed unreasonably, you may apply to the United
States District Court for relief, including interim benefits, if
appropriate. You may wish to consult an attorney regarding your rights.
Free legal services may be available if you qualify for them due to
financial need.
A list of attorneys, who may be able to provide free services, is
attached.
Attachment 7. Exhibit E: Social Security Field Office Notice of Initiating
Interim Benefits to Sharpe Class Members: Benefits
Not Timely Effectuated by SSA After Issuance of ALJ Decision
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Letterhead of Social Security |
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Field Office, including address |
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and telephone number |
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Date: |
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Social Security Number: |
Claimant's Name
Claimant's Address
Dear :
With your Supplemental Security Income (SSI) hearing decision, we sent you
a letter saying that your regular and retroactive benefit amounts would be
calculated within
(60 days/20 days because we do not need more information about your financial eligibility)
[cross out one] of the decision and that you should receive your regular
and retroactive benefits within
(75 days/35 days) [cross out one] of
the decision, unless special exceptions apply.
Because we have not calculated the amount of your regular SSI benefits
within this time limit, we will shortly begin sending you interim
payments. The amount we pay you will be our best estimate of your regular
benefit amount. These interim payments will continue until we compute the
correct amount of your SSI benefits and begin to pay you that amount.
These payments are being made under a federal district court order in
Sharpe v. Sullivan, 79 Civ. 1977 (CSH)
(S.D.N.Y.).
We will continue to pay you a monthly interim benefit check until we
actually calculate and send you your regular monthly benefits. When we
make this calculation, we may learn that the amount of interim benefits
that we paid to you is either higher or lower than the regular benefits
due you for the same time period.
If at that time we decide that the amount of the interim benefits you were
paid is higher than your regular
benefit amount, we will decide that you were overpaid and will mail you a
written notice that explains how we computed the overpayment, how we will
seek to collect the overpayment, and how you may appeal our overpayment
determination. The notice will also tell you how you may request a waiver
of the overpayment. If we agree to waive the overpayment, we will not take
any steps to collect the overpaid amount from you.
However, if at that time we decide that the amount of the interim benefits
you received is lower than the
amount you should have received, we will promptly pay you the amount by
which you were underpaid. We will also send you a written notice that
explains how the underpayment was computed.
If you do not begin to receive these special interim payments within two
weeks of the date of this letter, or do not wish to receive them, you may
call a claims representative at ____________.
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Name |
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Field Office Manager |
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