Last Update: 7/22/2005 (Transmittal I-2-59)
HA 01240.099 Case
Processing When a Claimant Moves Into or Out of a Prototype State
During the Appeals Process
Renumbered from HALLEX section I-2-4-99
|
Claimant moves...
|
To...
|
Then the appeal
level is a...
|
|
After the initial disability determination,
but before appeal, from a:
|
|
|
|
Prototype DDS
|
another Prototype DDS
|
hearing
|
|
Prototype DDS
|
a non-Prototype DDS
|
reconsideration*
|
|
non-Prototype DDS
|
a Prototype DDS
|
reconsideration, because the claimant
did not have the benefit of a Claimant Conference
|
|
After the initial disability determination
and after requesting appeal (reconsideration), i.e., from a non-Prototype
DDS
|
Prototype DDS
|
reconsideration
|
|
After the initial disability determination
and after requesting appeal (hearing), from a:
|
|
|
|
Prototype DDS
|
another Prototype DDS
|
hearing
|
|
Prototype
|
a non-Prototype DDS
|
hearing
|
* regardless of any Prototype notice
with appeal rights to a hearing
Example 1
A claimant in the Prototype requests an appeal (hearing) of
the initial disability determination prior to moving to a non-Prototype
State. Moving to a non-Prototype State drops the case from the process
to the current process; however, because the claimant is already
at the hearing level before the case drops out, the claim will not
revert back to the reconsideration level, but will remain at the
hearing level.
Example 2
A claimant in the Prototype receives an unfavorable disability
determination and then moves to a non-Prototype State where she
contacts the FO about filing an appeal. Moving to a non-Prototype State
drops her case from the Prototype and, because she moved to the
non-Prototype State before requesting appeal, the proper appeal
on her claim is reconsideration, regardless of the fact that she received
a notice stating her appeal rights were to a hearing.