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HALLEX I-2-001

Office of Hearings and Appeals

Social Security Administration (S.S.A.)

Department of Health and Human Services

Volume I

Division II: Administrative Law Judge Hearings

Subject: Initial Processing of a Request for Hearing

Chapter: I-2-000

June 30, 1994

Current through March 1997

I-2-001 HEARING BEFORE AN ADMINISTRATIVE LAW JUDGE--GENERAL

Citations: Social Security Act §§ 205(a) and (b), and 1631(c) > 20 CFR §§ 404.929 - 404.930, 404.936, 410.630, 410.634, 416.1429 - 416.1430, 416.1436, and 422.203

The Secretary of Health and Human Services has delegated to Administrative Law Judges (ALJs) in the Office of Hearings and Appeals (OHA), the authority to hear and decide appealed determinations of claims for retirement, survivor and disability benefits under title II; aged, blind and disability benefits under title XVI; certain health insurance benefits under title XVIII; and certain black lung benefits under the Federal Mine Safety and Health Act of 1977.

The Associate Commissioner for Hearings and Appeals manages the hearing process through a nationwide network of hearing offices (HOs). The Associate Commissioner, through the Office of the Chief ALJ, designates the geographic area that each hearing office (HO) will serve and delegates to each Hearing Office Chief ALJ the authority to assign ALJs to hold hearings, issue decisions or orders, and take other appropriate action to resolve disputed issues.

"Claimant," as used herein, refers to the party to the initial, reconsidered, or revised determination who has requested a hearing before an ALJ, and any other party to the determination, or person whose rights may be adversely affected by a hearing decision. (See > I-2-145, Parties to the Hearing.)

 

 

 

HALLEX I-2-005

Office of Hearings and Appeals

Social Security Administration (S.S.A.)

Department of Health and Human Services

Volume I

Division II: Administrative Law Judge Hearings

Subject: Initial Processing of a Request for Hearing

Chapter: I-2-000

June 30, 1994

Current through March 1997

I-2-005 HEARING OFFICE CHIEF ADMINISTRATIVE LAW JUDGE, ADMINISTRATIVE LAW JUDGE AND HEARING OFFICE STAFF RESPONSIBILITIES (REVISED 06/93)

A. Hearing Office Chief Administrative Law Judge (HOCALJ) Responsibilities

In addition to hearing and deciding cases, the Hearing Office Chief Administrative Law Judge (HOCALJ), under delegation from the Chief Administrative Law Judge, has the authority to assign cases to ALJs. The HOCALJ has administrative and managerial responsibility for all personnel in the hearing office (HO) and provides overall guidance and direction regarding adherence to time and attendance procedures; staffing, space, equipment and expert witness needs; rotational assignment of cases and review of work products; application of performance standards and appraisals; and approval of travel vouchers, itineraries and expenditures. The HOCALJ provides advice and guidance to ALJs regarding the interpretation of applicable law, regulations, rulings and judicial precedents. The HOCALJ participates in investigations, in coordination with the Regional Chief Administrative Law Judge, into allegations of misconduct on the part of any employee, including ALJs, ensures compliance with the principles of equal employment opportunity and OHA's Affirmative Employment Plan, and conducts labor management functions consistent with collective bargaining agreements. The HOCALJ also ensures the timely and accurate response to public and congressional inquiries; performs liaison functions between the HO and various federal and local government agencies, including bar associations, medical and vocational rehabilitation associations; and conducts periodic training.

B. Administrative Law Judge (ALJ) Responsibilities

When a case is assigned to an ALJ for a hearing and decision, the ALJ is responsible for all actions necessary to process the case. The ALJ's principal responsibilities are to hold a full and fair hearing and issue a legally sufficient and defensible decision.

C. Hearing Office (HO) Staff Responsibilities

Under the overall guidance and direction of the Hearing Office Chief ALJ and individual ALJs, the HO staff conducts initial case screening and preparation; establishes controls for the orderly processing of cases; acknowledges receipt of requests for hearings (RHs); prepares and maintains HO files; maintains a control system for all cases in the HO; assigns cases to ALJs from the master docket; conducts prehearing case analyses and workups; develops additional evidence or information; discloses proposed exhibits to claimants and representatives; schedules hearings; prepares and sends notices, status letters and other correspondence; and, writes, types and proofreads decisions and orders.

 

 

 

HALLEX I-2-010

Office of Hearings and Appeals

Social Security Administration (S.S.A.)

Department of Health and Human Services

Volume I

Division II: Administrative Law Judge Hearings

Subject: Initial Processing of a Request for Hearing

Chapter: I-2-000

June 30, 1994

Current through March 1997

I-2-010 INITIAL CASE SCREENING AND PREPARATION

The Administrative Law Judge (ALJ) must review every request for hearing (RH) to ensure that the case is within the jurisdiction of the Office of Hearings and Appeals and the venue of the hearing office (HO). Following receipt of the RH, the HO staff will conduct initial screening and case preparation as follows:

- Acknowledge receipt of the RH. (See > I-2-020, Acknowledgement of Request for Hearing.)

- Establish an HO case control on the Hearing Office Tracking System (HOTS). (See > I-2-030 A., HOTS.)

- Establish a case control in the Office of Hearings and Appeals Case Control System (OHACCS) in the Social Security Administration Data Acquisition and Retrieval System (SSADARS). (See > I-2-030 B., OHACCS.)

- Determine if the RH is a valid request. (See > I-2-040, Request for Hearing--Filing Requirements.)

- Determine if the RH was timely filed. (See > I-2-050, Timely Request for Hearing--Filing Requirements.)

- Determine if the HO has venue, i.e., if the claimant resides within the HO's service area. (See > I-2-070, Hearing Office Service Area.)

- Create an HO file. (See > I-2-080, Hearing Office File.)

- Request the claim file if it has not been received. (See > I-2-110, Claim Files.)

 

 

 

HALLEX I-2-020

Office of Hearings and Appeals

Social Security Administration (S.S.A.)

Department of Health and Human Services

Volume I

Division II: Administrative Law Judge Hearings

Subject: Initial Processing of a Request for Hearing

Chapter: I-2-000

June 30, 1994

Current through March 1997

I-2-020 ACKNOWLEDGEMENT OF REQUEST FOR HEARING

The hearing office (HO) must acknowledge receipt of each valid request for hearing (RH) as soon as possible, but no later than 30 days after the HO receives the RH.

A. Content of Acknowledgement Letters

The acknowledgement letter must advise the claimant of:

1. the right to submit additional evidence;

2. the right to be represented; and

3. the right to payment for certain travel expenses. (See > I-2-090, Sample 4, Enclosure--Reimbursement of Travel Expenses, and > I-2-310 F., Reimbursement of Travel Expenses.)

B. Represented Claimant

If the claimant has a representative, send the acknowledgement letter to the representative with a copy to the claimant. (See > I-2-090, Sample 1, Acknowledgement Letter--Oral Hearing Requested--Represented Claimant.)

C. Unrepresented Claimant

If the claimant does not have a representative, send the acknowledgement letter to the claimant and enclose a list of organizations which may provide representation. (See > I-2-090, Sample 2, Acknowledgement Letter--Oral Hearing Requested--Unrepresented Claimant, and Sample 3, Enclosure to Letter to Unrepresented Claimant.)

 

 

 

HALLEX I-2-030

Office of Hearings and Appeals

Social Security Administration (S.S.A.)

Department of Health and Human Services

Volume I

Division II: Administrative Law Judge Hearings

Subject: Initial Processing of a Request for Hearing

Chapter: I-2-000

June 30, 1994

Current through March 1997

I-2-030 ESTABLISHING CASE CONTROLS

Establish controls for the orderly processing of the case by adding it to the Hearing Office Tracking System (HOTS) and the Office of Hearings and Appeals Case Control System (OHACCS).

A. HOTS

When adding a case to HOTS, follow the procedures set forth in the HOTS User Manual.

B. OHACCS

When adding a case to OHACCS, follow the procedures set forth in the OHA Case Control System Handbook.

 

 

 

HALLEX I-2-040

Office of Hearings and Appeals

Social Security Administration (S.S.A.)

Department of Health and Human Services

Volume I

Division II: Administrative Law Judge Hearings

Subject: Initial Processing of a Request for Hearing

Chapter: I-2-000

June 30, 1994

Current through March 1997

I-2-040 REQUEST FOR HEARING--FILING REQUIREMENTS

Citations: > 20 CFR §§ 404.930 - 404.933; 410.630 - 410.632; and 416.1430 - 416.1433; > 42 CFR §§ 405.720 - 405.722, 473.40 - 473.42, and 498.40 - 498.42.

A. Who May File a Request for Hearing (RH)

A claimant or an individual properly authorized to represent the claimant, who is dissatisfied with a reconsidered or revised reconsideration determination, a revised initial determination not involving a medical issue, or a proposed revised decision based on new evidence, may file an RH.

B. Where to File the RH

1. A claimant may file an RH at any office of the Social Security Administration (SSA). This is usually a field office (FO), but it may also be a hearing office (HO).

2. A claimant residing outside the 50 states, the District of Columbia, American Samoa, Guam, the Northern Mariana Islands, Puerto Rico, or the Virgin Islands may file an RH at the Veterans Administration Regional Office in the Philippines or at any Office of the U.S. Foreign Service.

3. A qualified individual having ten or more years of service in the railroad industry may file an RH at an office of the Railroad Retirement Board.

C. How to File the RH

The claimant or a representative on the claimant's behalf, may file an RH by completing and signing one of two standard "Request for Hearing" forms, i.e., Form HA-501 or Form HA-5011, or by filing any written and signed communication which contains an express or implied statement of intent to request a hearing. The preprinted HA-501 and HA-5011 are snapout forms consisting of copies for the claimant, representative, claim file (CF), and the HO and FO servicing the claimant's address. The Form HA-5011 has an additional copy for the intermediary or peer review organization (PRO). Both forms are available in Spanish.

1. Form HA-501

The claimant should use Form HA-501 if the case involves disability insurance benefits (DIB), retirement and survivors insurance (RSI), supplemental security income (SSI), or questions of entitlement to health insurance under Part A or Part B of title XVIII of the Social Security Act.

2. Form HA-5011

The claimant should use Form HA-5011 if the case involves the amount of benefits payable under Part A of title XVIII, the hospital insurance program.

3. Written and Signed Statements

To be considered a valid RH, a written and signed communication by the claimant or representative must contain a clearly expressed or implied statement of the claimant's intent to request a hearing.

4. Completion of Forms HA-501 and HA-5011

If the HO receives a written and signed communication which constitutes an RH, the HO staff must complete the appropriate RH form as follows:

a. Type the claimant's name in the signature block.

It is not necessary to obtain the claimant's signature on the form because the claimant or representative will have already signed the written communication which constitutes the RH.

b. Enter the servicing FO code in the lower right corner of the form. This code can be found in the SSA Service Area Directory.

c. Enter the date the RH was filed. (See > I-2-050 B., Date of the RH.)

d. Obtain the signature of the Hearing Office Chief Administrative Law Judge or designee on the acknowledgement portion of the RH form.

e. Attach the actual written communication to the CF copy of the HO-prepared RH form.

f. Contact the servicing FO to verify the right to a hearing and to request the CF.

g. Distribute copies of the form as appropriate.

D. Congressional Interest

1. Congressional Letter Requests Hearing

If the HO receives a letter from a Member of Congress, which cites a claimant's dissatisfaction with a reconsideration or revised determination, and expressly states or implies that the Member is requesting a hearing on the claimant's behalf, accept the letter as a valid RH and take the following actions:

- Prepare a written response to acknowledge receipt of the congressional letter. In this response, inform the Member of Congress that the letter has been accepted as an RH on behalf of the claimant.

- Prepare Form HA-501 or HA-5011, as appropriate. (See I-2-040 C.4.)


- Ensure that the congressional letter is date-stamped and that the postmarked envelope in which the letter was mailed is not destroyed (for purposes of establishing the filing date).

NOTE: The Member of Congress will be deemed to be acting for, but not representing, the claimant or party. Therefore, do not enclose representation forms with the acknowledgement letter.

2. Congressional Letter Does Not Request Hearing

If the HO receives a letter from a Member of Congress which cites a claimant's dissatisfaction with a reconsideration or revised determination, and expressly states or implies that the claimant intends to request a hearing, accept the congressional letter as a protective filing and take the following actions:

- Prepare a written response to acknowledge receipt of the congressional letter. In this response, inform the Member of Congress that the letter will serve as a protective filing if the claimant files an RH. (See > 20 CFR §§ 404.630 and > 416.340 for requirements on use of a written statement as an application filing date.) Also, request that the Member advise the claimant to contact the appropriate FO if the claimant wishes to file an RH.

- Ensure that the congressional letter is date-stamped and that the postmarked envelope in which the letter was mailed is not destroyed (for purposes of establishing the protective filing date).

- Make a copy of the congressional letter and envelope for the HO files, and send the originals to the appropriate FO, along with a copy of the HO's acknowledgement of the congressional letter, for action following their usual procedures.

3. Congressional Phone Inquiry

If the HO receives a congressional telephone inquiry, prepare and date a report of contact (RC) to document the inquiry, inform the person making the inquiry that the inquiry will serve as a protective filing if the claimant files an RH, and forward the RC to the appropriate FO for action. Also, request that the person making the inquiry advise the claimant to contact the appropriate FO if he or she wishes to file an RH. (See > 20 CFR §§ 404.630 and > 416.340 for requirements for use of a written statement as an application filing date.)

 

 

 

HALLEX I-2-050

Office of Hearings and Appeals

Social Security Administration (S.S.A.)

Department of Health and Human Services

Volume I

Division II: Administrative Law Judge Hearings

Subject: Initial Processing of a Request for Hearing

Chapter: I-2-000

June 30, 1994

Current through March 1997

I-2-050 TIMELY REQUEST FOR HEARING--FILING REQUIREMENTS

A. When the Request for Hearing (RH) Must be Filed

1. The claimant, or representative on the claimant's behalf, must file an RH within 60 days (unless the time for filing is extended) from the date of receipt by the claimant of:

a. The notice of a reconsideration or a revised reconsideration determination;

b. The notice of revised initial determination in a non-disability case; or

c. The ALJ's notice of proposed revised decision based on new evidence. (404.992(c) and 416.1492(e)

2. When the last day for filing an RH falls on a Saturday, Sunday, legal holiday, or any other day which is not a full work day for Federal employees by statute or Executive Order, the time period for filing the RH is extended to include the next full work day.

B. Date of the RH

Ordinarily, we consider an RH filed as of the date it is received in any Social Security Administration office, or the date it is received by an employee of SSA authorized to receive an RH at a place other than an SSA office. We also accept as the date of filing the date an RH is received at the Veterans Administration Regional Office in the Philippines, or an office of the Railroad Retirement Board for persons having 10 or more years of service in the railroad industry. However, if an RH is mailed to us, and using the date we receive it would result in the loss or lessening of the claimant's rights, we accept the U.S. Postal Service stamp cancellation or "postmark" date on the envelope in which it is mailed to us. If the postmark is unreadable or there is no postmark, we consider the RH timely filed if we receive it by the 70th day after the date on the notice of the determination or decision being appealed (See I-2-050 C. below).

- If a claimant files Form HA-501 or HA-5011 at the HO, stamp the date of receipt in the upper right-hand corner of the form.

- If a claimant submits an RH to the HO in the form of a letter, stamp the date of receipt in the upper right-hand corner of the letter, and staple the mailing envelope to the letter.

- If an RH was filed in an FO or other office within the Social Security Administration, and the date the RH was received is unclear, contact the appropriate office by telephone to determine if they have any evidence of the date of receipt.

- If a copy of the notice of the determination is not in the file to establish its date, review the actual determination (e.g., Form SSA-831 in disability cases) and any computer printouts in the file to determine if they show the date of the determination, or contact the appropriate FO by telephone and request that they obtain and forward a copy of the notice of the determination.

C. Presumed Date of Receipt of Notice of Determination

We presume that a claimant received notice of a determination or decision within 5 days after the date of such notice, unless there is a reasonable showing to the contrary. If an RH is mailed to us, and the U.S. Postal Service stamp cancellation or postmark is unreadable or there is no postmark, we presume that the claimant mailed it to us no more than 5 days before we received it, unless there is evidence to the contrary.

- If an RH is received within 65 days of the date of the determination or decision, consider the RH timely filed.

- If an RH was not received within the 65-day period, but the U.S. Postal Service stamp cancellation or postmark shows that it was mailed within that period, use the postmark and consider the RH timely filed.

- If an RH is received by mail within 70 days of the date of the determination or decision, and the postmark is unreadable or there is no postmark, consider the RH timely filed.

D. RH not Filed Within the Prescribed Time Period

1. Any claimant who has a right to a hearing but does not file a timely request, may ask for an extension of time to make the request.

The request for an extension must be in writing and must give the reasons why the request was not filed within the required time period. (Most requests for an extension are in the form of an explanation for untimely filing written on or attached to the RH form.)

2. The ALJ must grant an extension for filing the RH if he or she determines that the claimant has established "good cause" for missing the filing deadline. (See > I-2-060, Good Cause for Late Filing.)

3. The ALJ must deny the request for an extension for filing the RH and dismiss the RH if the claimant does not show "good cause" for missing the deadline. (See > I-2-415, Hearing Request Not Timely Filed.)

 

 

 

HALLEX I-2-060

Office of Hearings and Appeals

Social Security Administration (S.S.A.)

Department of Health and Human Services

Volume I

Division 2: Administrative Law Judge Hearings

Subject: Initial Processing of a Request for Hearing

Chapter: I-2-000

February 21, 1997

Current through March 1997

I-2-060 GOOD CAUSE FOR LATE FILING

Citations:> 20 CFR §§ 404.911 and > 416.1411

A. Determining "Good Cause"

When determining whether a claimant had "good cause" for missing the deadline to request a hearing, consider the following:

1. What circumstances kept the claimant from making the request on time.

2. Whether our action misled the claimant.

3. Whether the claimant did not understand the requirements of the Act as a result of amendments to the Act, other legislation, or court decisions.

B. Examples of "Good Cause"

Examples of circumstances when "good cause" may exist include, but are not limited to, the following:

1. The claimant was seriously ill and was prevented by the illness from contacting us in person, in writing, or through a friend, relative or other person.

2. There was a death or serious illness in the claimant's family.

3. Important records were destroyed by fire or other uncontrollable event.

4. The claimant was trying to find necessary information to support the claim and did not find the information within the stated time period.

5. Within the time limit for requesting a hearing, the claimant requested an explanation or other information from the Social Security Administration regarding the determination being appealed, and within 60 days of receiving the information or explanation the claimant filed an RH.

6. SSA gave the claimant incorrect or incomplete information about when and how to request administrative review.

7. The claimant did not receive notice of the determination or decision.

8. Within the time limit for requesting a hearing, the claimant submitted an RH to another Government agency in good faith, and the RH did not reach us until after the time period had expired.

9. Unusual or unavoidable circumstances prevented the claimant from filing timely.

10. Evidence exists which shows that the claimant did not know of the need to file timely.

C. Development Procedures for Determining "Good Cause"

If nothing in the file exists to indicate the reason for the late filing, contact the claimant and request an explanation.

Also ask the servicing FO to forward any pertinent information in its files, e.g., any letter or communication from the claimant, representative, or the claimant's family, a copy of any records containing information regarding pertinent contacts, etc. The ALJ may also elect to obtain the needed information at a hearing on the issue of "good cause" for untimely filing.

 

 

 

HALLEX I-2-070

Office of Hearings and Appeals

Social Security Administration (S.S.A.)

Department of Health and Human Services

Volume I

Division 2: Administrative Law Judge Hearings

Subject: Initial Processing of a Request for Hearing

Chapter: I-2-000

February 21, 1997

Current through March 1997

I-2-070 HEARING OFFICE SERVICE AREA (REVISED 02/97)

A. General

Each hearing office (HO) has jurisdiction over a designated geographic area referred to as the HO's "service area." The HO will generally process all requests for hearing (RHs) of claimants residing in that area. In general, hearings will be held within 75 miles of the claimant's home.

SSA may only reimburse the claimant, the representative and unsubpoenaed witnesses for travel expenses if the distance between the HO and the person's residence or office, whichever he or she travels from, is more than 75 miles.

See > I-2-072 G., Reimbursement of Travel Expenses of Foreign Claimants; > I-2-090 Samples, Sample 4, ENCLOSURE -- REIMBURSEMENT OF TRAVEL EXPENSES; and > I-2-310 H., Reimbursement of Travel Expenses.

B. Screening RH to Determine Venue

When an HO receives an RH, the HO staff will screen the RH to determine if the HO has venue, i.e., whether the resident address of the claimant is in the geographic area the HO serves. If the HO does not have venue, the HO staff will forward the RH to the HO that does.

C. Changing Venue

Although a claimant may request a change of venue, i.e., request to have the case transferred to another HO, it is OHA's policy not to routinely grant such requests. Because of the large volume of cases in HOs, routine changes of venue would be disruptive and could adversely affect service to other claimants.

An ALJ may change venue upon a claimant's written or oral request if the claimant has "good cause" for making the request, or on the ALJ's own initiative if the change would promote the efficient administration of the hearing process and ensure the claimant a full and fair hearing. Examples of circumstance that could warrant a change of venue include, but are not limited to, the following:

- A witness who will testify to facts which are material to the claimant's case and which cannot be otherwise obtained, would be unable to travel to the place set for the hearing, but would be able to travel to another place if the hearing were held there.

- Transportation is not readily available for the claimant to travel to the place set for the hearing.

- The claimant lives closer to another hearing office.

- The claimant is confined in a prison or other institution and reasonable arrangements cannot be made to transport the claimant to the place set for the hearing. Under these circumstances, hearings may be held at the place of confinement.

NOTE 1: An ALJ may change venue only after contact has been made with the receiving HO to determine the impact the change would have on the efficient administration of the hearing process in that office.

NOTE 2: If an ALJ changes venue, he or she must notify all parties and the receiving HO of the change and the reasons for it.

 

 

 

HALLEX I-2-072

Office of Hearings and Appeals

Social Security Administration (S.S.A.)

Department of Health and Human Services

Volume I

Division 2: Administrative Law Judge Hearings

Subject: Initial Processing of a Request for Hearing

Chapter: I-2-000

February 21, 1997

Current through March 1997

I-2-072 ASSIGNING AND PROCESSING REQUESTS FOR HEARING FILED BY CLAIMANTS WHO DO NOT RESIDE IN THE UNITED STATES (REVISED 02/97)

A. General

A claimant has the right to appear before the ALJ, either personally or through a designated representative [> 20 CFR §§ 404.950(a) and > 416.1450(a)]. If a claimant lives outside the United States and does not inform the ALJ assigned to conduct the hearing that he or she wishes to appear, and there are no other parties to the hearing who wish to appear, the ALJ may decide the case on the record and not conduct a hearing [> 20 CFR §§ 404.948(b)(1)(ii) and > 416.1448(b)(1)(ii)].

Sections 201(j), 1631(h), and 1817(i) of the Social Security Act state the authority for the payment of certain travel expenses to claimants, representatives, and all reasonably necessary witnesses who attend ALJ hearings. This reimbursement is statutorily limited to travel within the United States. > 20 CFR §§ 404.999a ff. and 416.1495 ff. implement these statutory authorities.

Individuals who reside in "the States, the District of Columbia, the Commonwealth of Puerto Rico, the Virgin Islands, Guam, and American Samoa" are residents of the United States for the purposes of titles II and XVIII [see § 210(i)]. In addition, residents of the Northern Mariana Islands are residents of the United States if the individual is applying for special age 72 benefits under section 228 of title II. Individuals who live in the 50 States, the District of Columbia, and the Northern Mariana Islands are residents of the United States for the purposes of title XVI; however, an individual shall not be considered an eligible individual for any month during which such individual is outside the United States [> 20 CFR §416.1603(c)].

NOTE: "Foreign claimant," as defined herein, refers to residence, not citizenship.

See Temporary Instruction 5-110 for a discussion of the limitation on the amount available to reimburse a representative for travel to attend a hearing, effective for representative travel expenses incurred on or after April 1, 1991.

B. Foreign Claimant -- Title II or Title XVIII Claim

A claimant for title II or title XVIII benefits is a foreign claimant if he or she has requested a hearing and does not reside in the 50 States, the District of Columbia, American Samoa, Guam, Puerto Rico, or the Virgin Islands. A resident of the Northern Mariana Islands is a foreign claimant unless he or she is filing for special age 72 benefits under section 228 of title II of the Act or for title XVI benefits.

C. Foreign Claimant -- Title XVI Claim

A title XVI claimant is a foreign claimant if he or she has requested a hearing and does not reside in the 50 States, the District of Columbia, or the Northern Mariana Islands.

Therefore, title XVI requests for hearing from foreign claimants are ordinarily limited to cases in which:

- SSA issued the initial and reconsideration determinations on an individual's SSI application while the claimant was a United States resident, and

- Thereafter, the claimant moved out of the country.

The ALJ may find such claimant disabled or eligible for SSI benefits for the time the claimant resided in the United States during the pendency of the application.

D. Requirements for Filing a Request for Hearing

A claimant, including a foreign claimant, must request a hearing in writing [> 20 CFR §§ 404.933(a) and > 416.1433(a)]. The claimant may file the request at any SSA office or any United States Foreign Service Office [> 20 CFR § 404.614(b)(1)]. Foreign claimants may also file hearing requests on title II claims at the Veterans Administration Regional Office in the Philippines, or with the Railroad Retirement Board [> 20 CFR § 404.933(b)(2)].

E. Foreign Claimant Travel -- Residence and Reimbursement of Travel Expenses

The Social Security Act [§§ 201(j), 1631(h), and 1817(i)] authorizes expenditure of funds to pay travel expenses to claimants for travel within the United States to attend proceedings before ALJs. The implementing regulations [§§ 404.999c(d) and 416.1495] state that SSA will reimburse a claimant who travels more than 75 miles to a hearing site OHA selects. If a claimant travels to the United States from a foreign country for a hearing, SSA considers the point of entry (i.e., the location at which the claimant first enters the United States) to be his or her residence or office for the purpose of computing the 75 miles. Therefore, a foreign claimant is eligible for reimbursement of travel expenses when the hearing office (HO) to which OHA assigns the request for hearing (RH) schedules the hearing at a site more than 75 miles from the location of the claimant's point of entry into the United States.

 

F. Routing and Assignment of an RH From a Foreign Claimant

1. SSA's Office of Disability and International Operations (ODIO), in Baltimore, Maryland, has jurisdiction over cases involving foreign claimants (except Title XVI cases) and maintains claim folders for these cases.

Upon receipt of the "Claim File Copy" of an RH from a foreign claimant, ODIO will locate and prepare the claim folder and send it to:

Office of Hearings and Appeals, SSA

Office of the Chief Administrative Law Judge, DFPP

Suite 1500, One Skyline Tower

5107 Leesburg Pike

Falls Church, VA 22041-3255

2. Upon receipt from ODIO of a foreign claimant's RH and claim file, the Chief ALJ or designee will designate the hearing office (HO) that will conduct the hearing, and forward the request for hearing and claim file to that office for assignment to an ALJ. The Chief ALJ or designee will designate the HO as follows:

- If neither the foreign claimant, other claimant, or representative requests to appear at a hearing in the United States, the Chief ALJ or designee will designate an HO which can handle the case most expeditiously.

- If the foreign claimant does not wish to appear at a hearing in the United States, but a United States resident, who is either a claimant or claimant's representative, does wish to appear, the Chief ALJ or designee will designate the HO which services the residence of the claimant who is a United States resident, or the business office of a claimant's representative.

- If a foreign claimant requests to appear at a hearing in the United States, the Chief ALJ or designee will ordinarily designate the hearing office which is closest to the claimant's point of entry. However, an HO other than the one closest to the point of entry may be designated if it would promote the just and efficient administration of the hearing process. SSA will reimburse travel expenses as provided in I-2-072 G. below.

- If a foreign claimant requests to appear at a hearing in the United States at a location other than the originally designated HO (i.e., the HO closest to the claimant's point of entry or the HO which the Chief ALJ or designee determined would promote the just and efficient administration of the hearing process), the Chief ALJ or designee will consider the request in light of the criteria in > I-2-070 C., Changing Venue. If the request is granted, SSA will reimburse travel expenses only to the extent provided in I-2-072 G. 3., below.

G. Reimbursement of Travel Expenses of Foreign Claimants (See > I-2-310 H., Reimbursement of Travel Expenses.)

SSA reimburse a foreign claimant's travel expenses as follows:

1. If the designated HO schedules the hearing at a place within 75 miles of the claimant's point of entry, SSA will not reimburse travel expenses.

2. If the designated HO schedules the hearing at a place more than 75 miles from the claimant's point of entry, SSA may reimburse the claimant for travel to the hearing.

3. If a foreign claimant requests that the hearing be held in the service area of an HO other than the HO originally designated (i.e., the HO nearest the claimant's point of entry or the HO the Chief ALJ or designee decided would best facilitate the just and efficient administration of the hearing process), and the Chief ALJ or designee grants the request, SSA may reimburse travel expenses only if such expenses would have been payable had the hearing been held within the jurisdiction of the originally designated HO and only in the amount that would have then been payable.

H. Hearing Office Processing of the Request for Hearing

Upon receipt of the claim folders and the foreign claimant's request for hearing, the HO will process the request for hearing in accordance with usual procedures.

I. Reimbursement for Travel

If the foreign claimant, representative, or any necessary witnesses request reimbursement of travel expenses, the HO staff will follow the procedures in SSA Administrative Instructions Manual System (AIMS) Chapter 07, Instruction No. 26 (AIMS § 07.26.00 ff.) and the policy set forth in this section.

 

 

 

HALLEX I-2-080

Office of Hearings and Appeals

Social Security Administration (S.S.A.)

Department of Health and Human Services

Volume I

Division II: Administrative Law Judge Hearings

Subject: Initial Processing of a Request for Hearing

Chapter: I-2-000

June 30, 1994

Current through March 1997

I-2-080 HEARING OFFICE FILE

A. Hearing Office (HO) File--General

The HO file is an unofficial record of a case. It is prepared and maintained by the HO staff for the Administrative Law Judge's (ALJ's) use, primarily after the claim file is released from the HO to another component. For example, the HO file may be useful to an ALJ when evaluating a fee petition.

B. Preparing the HO file

Use a standard size file, type the claimant's name and Social Security number on a gummed label, and affix the label to the index tab on the file.

C. Content of the HO File

The content of the HO file is left to the judgment of an ALJ. ALJs may choose to include such documents as:

1. A copy of the request for hearing.

2. A copy of the notice of hearing.

3. A copy of the ALJ's decision or dismissal order.

4. A copy of the exhibit list (if one is prepared).

5. A copy of the hearing cassette envelope.

6. Copies of any congressional inquiries and the ALJ's responses thereto.

7. Copies of any correspondence with the claimant, other parties, representatives, expert witnesses, etc.

NOTE: The claim file (CF) is the official record of a case. Therefore, ensure that all documents which properly belong in the CF are placed in it. If the ALJ decides that any of these documents should be retained in the HO file, make and retain copies.

 

 

 

HALLEX I-2-090

Office of Hearings and Appeals

Social Security Administration (S.S.A.)

Department of Health and Human Services

Volume I

Division 2: Administrative Law Judge Hearings

Subject: Initial Processing of a Request for Hearing

Chapter: I-2-000

February 21, 1997

Current through March 1997

I-2-090 SAMPLES

SAMPLE 1

ACKNOWLEDGEMENT LETTER -- ORAL HEARING REQUESTED REPRESENTED CLAIMANT

- Addressee

Address

_______________________

_______________________

Dear __________:

We have received your client's request for hearing. We will notify you and your client in writing of the time and place of the hearing at least twenty (20) days before the date of the hearing.

If you or your client have any evidence that you did not previously submit, please send it to this office immediately. If you are unable to send the evidence before the hearing, please bring it with you to the hearing.

You and your client will be able to see all of the evidence in your client's file at the hearing. If you wish to see it sooner, or have any questions regarding the case, please call this office at __________. Please have your client's Social Security number available whenever you call.

Sincerely,

SAMPLE 2

ACKNOWLEDGEMENT LETTER -- ORAL HEARING REQUESTED

UNREPRESENTED CLAIMANT

` Addressee

Address

_______________________

_______________________

Dear __________:

We have received your request for hearing. We will notify you in writing of the time and place of the hearing at least twenty (20) days before the date of the hearing. You have indicated that you are not represented.

YOU HAVE THE RIGHT TO BE REPRESENTED BY AN ATTORNEY OR OTHER REPRESENTATIVE OF YOUR CHOICE. A representative can help you obtain evidence and help you and your witnesses, if any, prepare for the hearing. Also, a representative can question witnesses and present statements in support of your claim. If you wish to be represented, you should obtain a representative AS SOON AS POSSIBLE so your representative can begin preparing your case. Please phone us at the number shown above if you decide to obtain a representative.

If there is an attorney or other person whom you wish to act as your representative, you should contact that person promptly to avoid any undue delay in scheduling your hearing. If you are unable to find a representative, we have enclosed a list of organizations which may be able to help you locate one. As indicated on the enclosed list, some private attorneys may be willing to represent you and not charge a fee unless your claim is allowed. Your representative must obtain approval from the Social Security Administration for any fee charged. Also, if you are not able to pay for representation, and you believe you might qualify for free representation, the list contains names of organizations which may be able to help you.

If you have any evidence that you did not previously submit, please send it to this office immediately. If you are unable to send the evidence before the hearing, please bring it with you to the hearing.

You will be able to see all of the evidence in your file at the hearing. If you wish to see it sooner, or have any questions regarding your claim, please call this office at _______________. Please have your Social Security number available whenever you call.

Sincerely,

SAMPLE 3

ENCLOSURE TO LETTER TO UNREPRESENTED CLAIMANT

IMPORTANT NOTICE

IF YOU WANT A PRIVATE ATTORNEY to represent you, but have been unable to find one, you may obtain a private attorney by contacting one of the organizations shown below. The organization will refer you to a private practicing attorney who is familiar with representing claimants before the Social Security Administration. Some private attorneys may take your case under a fee arrangement whereby the attorney will not charge a fee unless your claim is allowed. The attorney must obtain approval from the Social Security Administration for any fees he or she charges.

NAME AND ADDRESS

OF ORGANIZATIONS SERVICES

(List Organization(s)) (Describe the Area(s) Serviced

by the Organization(s))

IF YOU ARE NOT ABLE TO PAY FOR REPRESENTATION and you believe you might qualify for free legal representation, you should contact one of the following organizations:

(List Organization(s)) (Describe the Area(s) Serviced

by the Organization(s))

COMMUNITY ORGANIZATIONS which may provide you with nonattorney representation are as follows:

 

(List Organization(s)) (Describe the Area(s) Serviced

by the Organization(s))

SAMPLE 4

ENCLOSURE -- REIMBURSEMENT OF TRAVEL EXPENSES

IMPORTANT INFORMATION ABOUT PAYMENT OF TRAVEL EXPENSES

An Administrative Law Judge (ALJ) may authorize reimbursement of reasonable travel expenses to a claimant, representative or unsubpoenaed lay or medical witness whose appearance the ALJ determines is reasonably necessary for a fair hearing, when such person must travel more than 75 miles one way to attend the hearing.

Sections 201(j), 1631(h), and 1817(i) of the Social Security Act, as amended, provide that the amount available for payment under these sections for travel by a representative to attend a proceeding before an ALJ or other adjudicator shall not exceed the maximum amount allowable under these sections for travel originating within the geographic area of the office having jurisdiction over such proceeding.

If you must travel more than 75 miles one-way from your home or office to attend the hearing, and wish to request payment for travel expenses, please submit your request with an itemized list of what you spent and supporting receipts, to the ALJ at the hearing. If you require unusual travel arrangements (such as meals, lodging, taxicabs or ambulance services) or would like to request advance payment of travel expenses, please contact the hearing office immediately. The ALJ must authorize unusual travel arrangements in advance, unless they are unexpected and unavoidable, and must decide whether the request for advance payment is reasonable and necessary.

"Reasonable" means that the amount of advance payment you requested is not more than we would pay for reimbursable travel expenses under the regulations. "Necessary" means that without the advance payment you would not have enough money to pay for your transportation to and from the hearing, and consequently would be unable to attend the hearing.

If we pay your travel expenses in advance, you must, within 20 days after the hearing, provide the ALJ an itemized list of what you spent and supporting receipts. If the advance payment exceeds the amount you are due, we will notify you of the amount of the overpayment, and give you 20 days from the date of the notice to repay that amount.

If you request a change in the hearing location the ALJ selected to a location further from your residence or office, we will not reimburse you any additional travel expenses.

 


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