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HALLEX I-4-002
Office of Hearings and Appeals
Social Security Administration (S.S.A.)
Department of Health and Human Services

Volume I
Division IV: Civil Action
Subject: OCA Functions and Responsibilities
Chapter: I-4-000

June 30, 1994

Current through June 1997

I-4-002 FUNCTIONS AND RESPONSIBILITIES OF THE OFFICE OF CIVIL ACTIONS

OCA is responsible for Office of Hearings and Appeals (OHA) actions on cases in which a civil action has been filed. These actions include acting on new court cases, conducting supplemental reviews of pending court cases, acting on remand orders from the court, and recommending whether to seek an appeal when a federal court makes a decision adverse to the Secretary. The types of cases include:

-- claims for benefits filed under titles II, XVI and XVIII of the Social Security Act, as amended, and title IV of the Federal Mine Safety and Health Act of 1977, as amended;

-- claims for individual enrollment to participate under Parts A or B of title XVIII of the Act; and

-- claims by hospitals, skilled nursing facilities and independent laboratories seeking certification or continued certification under title XVIII of the Social Security Act.

OCA provides professional and technical advice to the Associate Commissioner, the Appeals Council, the Chief Administrative Law Judge and other OHA officials in all cases in which a civil action has been filed.

OCA is also responsible for formulating, implementing, and evaluating OHA's litigation management strategy and is the focal point for representing that strategy to other Social Security Administration and the Department of Health and Human Services components. In consultation with the Litigation Staff in the Office of the Deputy Commissioner for Programs, OCA develops interpretive instructions for implementing class action court orders and precedential court decisions. OCA tracks and analyzes court case trends in order to:

-- disseminate information to guide adjudicators with respect to case law;

-- implement an effective appeals strategy; and

-- identify problem areas and make recommendations for corrective action.



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