DI 33001.001 The Disability Hearing Process — Title II and Title XVI

CITATIONS:

Social Security Act, section 205(b);

20 CFR 404.914-404.918, 404.992, 404.993, 416.1413b, 416.1414-416.1418, 416.1492, , 416.1493, and 422.140

A. Introduction to the disability hearing process

1. Disability hearings and reopenings

This chapter addresses disability hearings at the reconsideration level of appeal. These procedures generally refer to reconsiderations of medical cessations, but they also include adverse reopening determinations.

2. Explanation of terms

When using these procedures, remember:

•

the terms “Disability Hearing Officer (DHO) reconsidered determination” and the “DHO hearing decision” are synonymous;
•

the term “Disability Hearing Unit (DHU)” means the separate adjudicatory Disability Determination Services (DDS) unit established for the purpose of processing disability hearing cases; and
•

the terms “supervisory hearing officer (SHO)” and “DHO” refer to the DDS counterpart for these functions.

3. Availability of disability hearings

Disability hearings are available at the reconsideration level of appeal in:

•

CDR medical cessation cases;
•

CDR reopenings that change only the basis for the cessation;
•

Adverse reopenings at the initial level (cases involving favorable initial CDR determinations which were reopened and revised to unfavorable or only partially favorable determinations) based on medical factors;
•

Adverse reopenings of cases involving favorable reconsideration CDR determinations which were reopened and which we propose to adversely revise based on medical factors.

Note:

For additional information about the claimant’s right to a disability hearing at the medical CDR reconsideration level, refer to DI 29001.001. For DHO reopening policy, refer to DI 33020.025.

B. Federal and State disability hearings

We conduct hearings at both State and Federal levels. If you need to modify these procedures to conform to State business processes, you cannot modify them in any manner that would conflict with the Federal regulations governing disability hearings.

A Federal DHO may conduct hearings where SSA made the determination under appeal, such as railroad and foreign claims. The Associate Commissioner for the Office of Disability Determinations, or delegate, appoints Federal DHOs. There may be circumstances when a Federal DHO assists State DHUs.

C. Who may conduct a disability hearing

Experienced disability adjudicators who have completed Social Security Administration (SSA) DHO training may conduct disability hearings. These individuals:

•

must have had no involvement in making the determination under appeal, i.e. the initial continuing disability review (CDR) cessation or adverse reopening, or the pre-hearing (PH) affirmation of the initial CDR cessation,

and
•

are part of an adjudicatory unit of a state agency or Federal component (DHU) other than the adjudicatory unit that made the determination under appeal (DDS).

D. List of forms commonly used in disability hearing cases

Form	Form Title
OF-347	Order for Supplies or Services
SSA-381-SP	Waiver of Right to Receive Notices In Spanish
SSA-408	Route Slip
SSA-416	Medical Evaluation
SSA-454-BK	Continuing Disability Review Report
SSA-454-BK-SP	Continuing Disability Review Report - Spanish
SSA-533	Translation Request
SSA-567	Notice for Subsequent Handling
SSA-765	Response to Notice of Revised Determination
SSA-769-U4	Request for Change in Time/Place of Disability Hearing
SSA-770-U4	Notice Regarding Substitution of Party Upon Death of Claimant-Reconsideration of Disability Cessation
SSA-773-U4	Waiver of Right to Appear-Disability Hearing
SSA-789-U4	Request for Reconsideration-Disability Cessation Right to Appear
SSA-795	Statement of Claimant or Other Person
SSA-831	Disability Determination and Transmittal
SSA-832	Cessation or Continuance of Disability or Blindness Determination and Transmittal-Title XVI
SSA-833	Cessation or Continuance of Disability or Blindness Determination and Transmittal-Title II
SSA-887	Summary of Evidence
SSA-1128	Representative Involved
SSA-1204-BK	Disability Hearing Officer's Report of Disability Hearing (DC)
SSA-1205-BK	Disability Hearing Officer's Report of Disability Hearing
SSA-1207-BK	Disability Hearing Officer’s Decision (DIB, CDB, DWB (Including Surviving Divorced Spouse), DI, DS
SSA-1207-BK-OP1	Disability Hearing Officer’s Decision (Medical Improvement Review Standard Not Applicable)
SSA-1209-BK	Disability Hearing Officer’s Decision (Title XVI Disabled Child (DC)) – Continuing Disability Review
SSA-1272-U4	Subpoena-Disability Hearing
SSA-L1648-U2	Disability Hearing Decision Letter - Without Benefit Continuation - Auxiliary
SSA-L1656-U2	Disability Hearing Decision Letter - Benefit Continuation Elected at Reconsideration and Offered Again at Administrative Law Judge (ALJ) Hearing Level - Auxiliary
SSA-L1658-U2	Disability Hearing Decision Letter - Benefit Continuation Not Elected at Reconsideration and Offered Again at ALJ Hearing Level - Auxiliary
SSA-L1674-U2	Disability Hearing Decision Cover Letter - Without Benefit Continuation
SSA-L1675-U2	Disability Hearing Decision Cover Letter - Benefit Continuation Elected at Reconsideration and Offered Again at ALJ Hearing Level
SSA-L1677-U2	Disability Hearing Decision Cover Letter - Benefit Continuation Not Elected at Reconsideration and Offered Again at ALJ Hearing Level
SSA-L1678-U2	Disability Hearing Decision Cover Letter - Without Payment Continuation
SSA-L1679-U2	Disability Hearing Decision Cover Letter - Payment Continuation Not Elected at Reconsideration and Offered Again at ALJ Hearing Level
SSA-L1680-U2	Disability Hearing Decision Cover Letter - Payment Continuation Elected at Reconsideration and Offered Again at ALJ Hearing Level
SSA-L1696-U4	Appointment of Representative
SSA-2506-BK	Psychiatric Review Technique
SSA-2640	Disability Hearing Case
SSA-3031	Disability Hearing Review Sample Case Flag
SSA-3441-BK	Disability Report -- Appeal
SSA-3441-BK-SP	Disability Report – Appeal (Spanish)
SSA-4734-BK	Physical Residual Functional Capacity Assessment
SSA-4734-F4-SUP	Mental Residual Functional Capacity Assessment

To Link to this section - Use this URL:
http://policy.ssa.gov/poms.nsf/lnx/0433001001

DI 33001.001 - The Disability Hearing Process — Title II and Title XVI - 08/16/2023
Batch run: 08/16/2023
Rev:08/16/2023

Program Operations Manual System (POMS)