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HALLEX I-1-601

Office of Hearings and Appeals

Social Security Administration (S.S.A.)

Department of Health and Human Services

Volume I

Division I: General Subjects

Subject: Congressional Inquiries

Chapter: I-1-600

June 30, 1994

Current through March 1997

I-1-601 CONGRESSIONAL INQUIRIES AT HEARING OFFICES

A. General

Administrative Law Judges (ALJs) and hearing office (HO) staffs must:

- Give high priority to inquiries received from Members of Congress and their staffs;

- Respond to congressional inquiries promptly, accurately and courteously; and

- Communicate any concerns about a particular inquiry to the congressional office that made the inquiry, the Office of the Regional Chief ALJ, and the Office of the Chief ALJ.

NOTE: In addition to congressional inquiries, inquiries from some other offices should be considered high priority. These include: the White House, Office of the Vice President and Cabinet Members; State Governors and legislators; the Federal Bureau of Investigation and other Federal law enforcement agencies when fraud or other criminal acts are alleged or implied; and the media. Consult with the Hearing Office Manager to determine how to treat these types of inquiries.

B. Telephone Inquiries from Members of Congress

Whether an inquiry is made by telephone or by letter, usually an HO legal clerk is responsible for handling the inquiry. If the initial inquiry is made by telephone:

1. Obtain either a Hearing Office Tracking System (HOTS) query or a Customer Information Control System (CICS) query to determine the case status.

2. If possible, provide case status and all other requested information during the initial call. When the status of a case is not immediately available, advise the congressional staff member that he or she will receive a call back within 48 hours.

3. Prepare a report of contact (RC). Include in the RC the congressperson's and staff member's names, their telephone number, and the claimant's name and Social Security number. Record the information given to the staff member, and sign and date the report.

4. Place a copy of the RC in the ALJ file and a copy in the claim file (CF).

5. Update HOTS to note the congressional interest.

6. Attach a congressional inquiry flag (Form SSA-5800) to the front of the CF at the bottom right corner.

C. Written Inquiries from Members of Congress

If the initial inquiry is a letter or a route slip:

1. Date-stamp the correspondence and associate it with the CF. Place a copy of the correspondence in the ALJ file.

2. Update HOTS to note the congressional interest.

3. Attach a congressional inquiry flag (Form SSA-5800) to the front of the CF at the bottom right corner.

D. Interim Responses to Written Inquiries

1. Acknowledge receipt of a written inquiry within 7 working days. The initial response should convey as much information as possible about the case. If there is a problem obtaining information initially, send a letter advising that attention is being given to the inquiry and further information will be provided as soon as possible.

2. If the case is not assigned to an ALJ, the HO Chief ALJ signs the response. If the case is assigned, the ALJ signs the response.

3. If acceptable to the congressperson, interim responses to written inquiries may be made by telephone; however, an RC must be completed and a copy placed in both the ALJ file and the CF.

E. Diarying the Inquiry

After an initial response is made, whether by telephone or by letter, the inquiry is diaried for follow-up responses:

1. Diary the inquiry for 30 days on HOTS.

2. At the end of the 30 days, send a letter or make a telephone call to convey the updated status of the case.

3. Re-diary the inquiry for 30 days on HOTS. Continue to follow-up and rediary every 30 days until the final response is released.

F. Final Responses

When the final disposition is ready, prepare a written final response. Include in the final letter the type of decision or order and, if appropriate, where the CF will be sent.

NOTE: The final congressional response should be released the same day as the ALJ's decision or order.

G. Non-routine Congressional Inquiries

Refer congressionals of a non-routine nature to the HOCALJ or the Regional Chief ALJ. Non-routine inquiries include issues such as backlogs, processing times personnel matters and allegations of ALJ Bias/Misconduct.

H. Appeals Council Remand Cases with Congressional Interest

If the HO receives an Appeals Council remand case that already has a congressional inquiry flag attached to the front of the CF or congressional interest noted in the CF, advise the congressional office, either by telephone or in writing, that the HO has received the case back from the Appeals Council. Provide status reports to the congressional staff member every 30 days, as well as a final response when the ALJ issues a decision.

 

I. Notification of Congressional Interest from the Office of Hearings and Appeals (OHA), Division of Congressional and Public Inquiries (DCPI)

If a congressperson or his or her staff member contacts OHA's Associate Commissioner regarding an HO case, DCPI is responsible for obtaining status on the case, preparing an interim response, and routing the congressional inquiry to the HO. Therefore, if the HO receives a telephone call from a DCPI staff member, the HO contact should:

1. Give him or her the status of the case.

2. Update HOTS to show congressional interest and attach a congressional inquiry flag (Form SSA-5800) to the front of the CF at the bottom right corner. The DCPI staff member will forward a copy of the congressional inquiry for association with the CF.

3. When the inquiry and interim response are received from DCPI, place a copy in the ALJ file, associate the inquiry and response with the CF, and input an appropriate diary date on HOTS for a follow-up response (30 days from the date of DCPI's response). Then follow insructions E. and F. above until the case is closed.

NOTE: Refer to macros at > I-1-590, Samples, for language to use when responding to congressionals at the hearing level.

 

 

HALLEX I-1-610

Office of Hearings and Appeals

Social Security Administration (S.S.A.)

Department of Health and Human Services

Volume I

Division I: General Subjects

Subject: Congressional Inquiries

Chapter: I-1-600

June 30, 1994

Current through March 1997

I-1-610 CONGRESSIONAL INQUIRIES AT HEADQUARTERS

A. General

The Division of Congressional and Public Inquiries (DCPI) serves as the primary liaison between the Office of Hearings and Appeals (OHA) and Members of Congress on case-related matters. The DCPI staff prepares responses to both routine and sensitive written and telephone inquiries, formulates correspondence guidelines, and monitors the quality of congressional responses released by OHA. The Division of Congressional and Public Inquiries' work is critical to ensuring good relations between OHA and Congress.

B. Telephone Inquiries from Members of Congress

The Telephone Inquiries Branch (TIB) is the component responsible for receiving and responding to telephone calls from Members of Congress and their staffs.

NOTE: If an employee in another OHA Headquarters component, excluding the Executive Secretariat (ES), receives a telephone call from a congressperson or a congressional staff member regarding a pending OHA case, the call should be referred to the TIB at 305-0290.

The Inquiries Assistants (IAs) and Inquiries Specialists (Specialists) in the TIB process the congressional inquiries received by telephone, as follows:

1. If a congressional staff member requests only general information or indicates he or she does not need follow-up status reports, or if the staff member is referred to another office, there is no need to prepare a report of contact (RC). These calls are recorded as a stroke tally on the "Closed Without Write-Up Calls" form.

2. When a congressional telephone inquiry is received in the TIB about a case pending with OHA, an IA or a Specialist obtains a CICS query and prepares an RC. The RC includes the congressperson's and staff member's names, their telephone number, and the claimant's name and Social Security number. The RC also notes exactly what type of information the staff member is requesting.

3. If there is no CICS summary query attached to the RC, an IA obtains a CICS summary printout and attaches it to the RC.

4. An IA obtains a pre-update search on the Inquiry Response Information System (IRIS) to determine if any previous inquiries have been received on the case.

5. An Operations Analyst reviews the RCs and places an Automated Document Control and Retrieval system (ADCAR) subject-matter coding sheet on the inquiry folder, indicating the pending level of adjudication and the subject matter of the inquiry.

6. An IA assigns the inquiries to the TIB staff on a rotating basis. However, if a DCPI employee, whether in the TIB or in one of the Written Inquiries Branches (WIBs), has an open or closed inquiry about the case, the telephone call is assigned to that employee.

7. An IA inputs on the IRIS and the ADCAR systems the name of the person to whom the case is assigned and annotates the Specialist's code and the date of assignment on the hard copies of these systems forms.

8. After an inquiry is assigned, the Specialist contacts the appropriate OHA, SSA, or other office to obtain status on the case. The Specialist carefully documents on the RC the office contacted, its telephone number, the name of the person providing the information, and all status information obtained.

9. The Specialist advises the component handling the case that there is congressional interest and requests that the CF be flagged.

10. If the case is pending in an Office of Appellate Operations (OAO) Program Review Branch (PRB), the Specialist:

- Advises the PRB contact person that there is congressional interest and requests that the contact attach a yellow DCPI Case Flag, Form HA-282, to the front of the CF at the lower right corner.

- Advises the PRB contact of any pertinent information provided by the congressional staff member regarding the case.

NOTE: The PRB staffs are responsible for routing congressional interest CFs through DCPI when they are sent to an Administrative Appeals Judge (AAJ) with a grant review notice, final action or final reply.

11. If the case is pending in a Division of the Office of Civil Actions (OCA), the Specialist:

- Obtains status from the Division contact person.

- Checks monthly to obtain updated status reports until the OCA Division completes its action on the case. Usually OCA cases are not routed through DCPI, so the Specialist must continue to check the status and rely on oral information until the case is closed.

12. The Specialist calls the congressional staff member back within 48 hours of the original call, conveys case status, and advises that DCPI will provide status reports every 30 to 60 days, as well as a written response when the Appeals Council issues its action, order or decision.

13. If the inquiry concerns a case pending in an HO, the Specialist advises the congressional staff member of the status and that we have informed the HO staff of the congressional interest. The Specialist then forwards the inquiry to the HO for further responses, including a written final reply.

14. The Specialist annotates the RC with the information provided to the congressional staff member and updates the IRIS and ADCAR forms with the response code and the date.

15. An IA inputs the IRIS and ADCAR systems information and diaries the case for 30 to 60 days, as directed by the Specialist.

16. For cases pending in an OAO PRB, the Specialist continues to provide monthly or bimonthly telephone status responses until the TIB receives the CF en route to an AAJ. The Specialist then prepares a written response based on the OAO Analyst's recommendation to the AAJ. The final response will be released by the AAJ's Assistant or the PRB's Release Clerk when the final action, order or decision is released.

17. The Specialist places the written response in a red congressional inquiry folder and reattaches the yellow flag to the front of the red folder. The flag is annotated to
request the AAJ's Assistant or the PRB's Release Clerk to date-stamp and return the flag to DCPI when the congressional response has been released. The Specialist annotates the ADCAR and IRIS forms with the AAJ's code and routes the CF to the AAJ.

18. When the Specialist receives the congressional flag showing that the response has been released, he or she annotates the IRIS and ADCAR systems sheets to show that a final letter has been released. An IA updates the IRIS and ADCAR systems.

 

C. Written Inquiries from Members of Congress

The Division of Congressional and Public Inquiries has three Written Inquiries Branches (WIBs) that handle written congressional inquiries about pending appeals cases. These branches also refer, as necessary, inquiries about cases pending at the hearing level, at another SSA component or at another Government agency to the appropriate office.

NOTE: Forward all written congressional inquiries to DCPI, unless they are received in ES and ES determines that it should handle.

Guidelines for processing written congressional inquiries are as follows:

1. The DCPI mail clerk opens the mail, date-stamps all congressional inquiries, and obtains CICS summary queries.

2. A Typing and Control Clerk (TCC) obtains an IRIS pre-update search to determine if any DCPI employee has an open or closed inquiry on the case.

3. An Operations Analyst (OA) reviews the congressional inquiries and places an ADCAR subject-matter coding sheet, which indicates the level of adjudication and subject of the inquiry, on the control folders.

An OA also screens the inquiries and determines which should be referred to ES because of policy questions, processing time questions, personnel matters, etc. These inquiries also have an ADCAR coding sheet attached to the control folder. They are then assigned to ES on the ADCAR system and routed to that office for a response or for assignment to another component.

Invitations and thank-you letters to the Associate Commissioner are forwarded directly to the Associate Commissioner's office and are not controlled on the ADCAR and IRIS systems.

4. Inquiries are assigned to Congressional and Public Inquiries (CPI) Analysts on a rotating basis. However, if a DCPI employee, whether in a WIB or in the TIB, has an open or closed inquiry on the case, the inquiry is assigned to that employee.

5. A TCC inputs on the IRIS and ADCAR systems the name of the person to whom the case is assigned and annotates the CPI Analyst's code and the date of assignment on the hard copies of these systems forms.

6. After an inquiry is assigned, the CPI Analyst contacts the appropriate OHA, SSA or other office to obtain status on the case. The CPI Analyst carefully documents on a RC the office contacted, its telephone number, the name of the person providing the information, and all status information obtained.

7. If the case is pending in an OAO PRB, the CPI Analyst:

- Advises the PRB contact person that there is congressional interest and requests that the contact attach a yellow DCPI Case Flag, Form HA-282, to the front of the CF at the lower right hand corner.

- Advises the PRB contact if there is additional medical or other information attached to the congressional, and, if so, that it will be forwarded for association.

NOTE: The PRB staffs are responsible for routing congressional interest CFs through DCPI when the CFs are sent to an AAJ with a grant review notice, final action or final reply.

8. If the case is pending in an OCA Division, the CPI Analyst:

- Advises the OCA contact person that there is congressional interest and obtains status on the case.

- Checks monthly to obtain updated status reports until the OCA Division completes its action on the case.

9. If the case is pending in an HO, the CPI Analyst:

- Advises the HO that there is congressional interest in the case and requests that the congressional interest be noted on HOTS and that the CF be flagged.

- Advises the HO that DCPI will send an interim response and forward the congressional inquiry and a copy of the response to the HO for further responses and a final reply.

10. If the case is pending with another SSA component, the CPI Analyst:

- Advises the component of congressional interest and requests that the interest be noted in the CF.

- Advises the component that DCPI will prepare an interim response and forward the congressional inquiry and a copy of the response for association with the CF.

11. If the inquiry concerns a non-SSA case or issue, the CPI Analyst refers it to the appropriate Government or non-Government office.

12. An initial response to the congressional inquiry should be released within 7 days from the date the inquiry was assigned to the CPI Analyst. When the status of the case has been obtained, the CPI Analyst:

- Prepares a response in WordPerfect using either language from DCPI's Macro-Text or, when necessary, original language. The Macro-Text's accompanying guide gives information about using macros when preparing letters.

- Prints an original letter, a courtesy copy, a yellow file box (YFB) copy and a CPI Analyst's copy.

13. The CPI Analyst signs the YFB copy of the letter, assembles the letter and copies inside the control folder, and annotates the IRIS and ADCAR forms with the appropriate response code. If the letter is being referred to another office, the CPI Analyst annotates the office under "Remarks" on the ADCAR form.

14. The CPI Analyst then forwards the control folder to the supervisor for review. If the supervisor finds errors, he or she returns it for corrections. If the letter is complete, the supervisor signs the YFB copy and forwards the control folder to an OA for quality review.

15. The OAs review an approximate 20-percent random sample of congressional replies. The OAs sign the YFB copy of the letters that are complete and return to the supervisors any letters that need corrections or revisions.

16. All letters are then sent to the Typing and Control Branch for the Associate Commissioner's autopen signature, date-stamping and releasing, annotating of the release date and due date on the IRIS and ADCAR forms, and input into IRIS and ADCAR the type of response, release date and due date.

17. A TCC then returns any open control folders to the appropriate CPI Analyst.

18. The CPI Analyst diaries the inquiry and pulls the folder approximately 2 weeks before the due date to obtain an updated status report and to
prepare another response. The CPI Analyst obtains an updated status report and follows steps 12 through 17 until the CF comes to DCPI for preparation of the final response based on the OAO Analyst's recommended action.

If the CF, routed to an AAJ, arrives in DCPI before the due date, the CPI Analyst prepares another interim response, if appropriate, and a final response that will be released by the AAJ's assistant or the PRB's release clerk when the Appeals Council's action, order or decision is issued.

19. When preparing a final response, the CPI Analyst uses DCPI's Macro-Text or original language. The copy requirements remain the same as in step 12, unless the case is being remanded. If the case is being remanded, the CPI Analyst prepares an extra copy, which will be sent to the appropriate OHA Regional Office. The original congressional inquiry and any YFB copies of responses are placed in the CF.

20. If another interim response has been prepared, the CPI Analyst places it on the right side of the control folder. The CPI Analyst staples a copy of the final response to the inside left of the control folder. The CPI Analyst places the final response, courtesy copy and YFB copy in a red congressional inquiry folder and reattaches the yellow DCPI Case Flag (Form HA-282) to the front of the red folder. The flag is annotated to request the AAJ's assistant or the PRB's release clerk to date-stamp and return the flag to DCPI when the congressional response has been released. The CPI Analyst annotates the ADCAR and IRIS forms with the AAJ's code.

21. The CPI Analyst routes the CF, ADCAR folder, and congressional folder to his or her supervisor for the process in steps 14 through 17. Additionally, the TCC routes the CF to the designated AAJ.

22. When the yellow flag is returned to DCPI, the CPI Analyst annotates the ADCAR and IRIS forms with a final letter code and the date of release, and forwards the ADCAR folder to the T & CB for input of the final response into the IRIS and ADCAR systems.


NOTE: If an AAJ returns the CF to an OAO Analyst to prepare a different type of final action, order or decision, the OAO Analyst and PRB are responsible for rerouting the CF through DCPI so that the final response can be revised.

D. Congressional Inquiries Received in the Executive Secretariat (ES)

ES handles the most sensitive of case-related congressional inquiries, as well as non case-related congressionals with issues such as backlogs, processing times, and personnel matters. Some of these inquiries are received directly in ES and others are routed to ES from DCPI following the OA's screening process.

DCPI controls inquiries sent to ES on the ADCAR system. Copies of congressional inquiries received directly in ES should be forwarded to DCPI for preparation of an ADCAR folder and return to ES.

ES may prepare a response to a congressional inquiry or assign it to another OHA component for preparation of a response. If ES assigns the inquiry to another component, it will provide instructions for preparing a response.

Components may use the OHA Guide to Written Communications for format, address and salutation guidelines when preparing a congressional response. When a final reply has been released, ES will return the ADCAR folder to DCPI for close-out of the inquiry on the ADCAR system.

 

 

 

HALLEX I-1-690

Office of Hearings and Appeals

Social Security Administration (S.S.A.)

Department of Health and Human Services

Volume I

Division I: General Subjects

Subject: Congressional Inquiries

Chapter: I-1-600

June 30, 1994

Current through March 1997

I-1-690 SAMPLES

Language for Congressional Responses for Cases Pending at the Hearing Level

Introductory Paragraphs

HOI1--Initial Response

This is in response to your inquiry of *DATE regarding *CLMT NAME *(SSN).

HOI2--Further Response

This is in further response to your inquiry regarding *CLMT NAME *(SSN).

Pending Paragraphs

HO1--R/H and CF Received

We have received *CLMT NAME's request for hearing and are preparing the file for assignment to an Administrative Law Judge. We will inform you of any developments in the case.

HO2--R/O and CF Received

We have received *CLMT NAME's file with the Appeals Council's *DATE remand order. We will inform you of any further developments in the case.

HO3--R/H Assigned to ALJ--Pre-Hearing Development

*CLMT NAME's request for hearing has been assigned to me and I have requested additional evidence on the case. I will inform you of any further action in this case.

HO4--R/H Assigned to ALJ--Hearing Unscheduled

*CLMT NAME's case has been assigned to me and I will schedule HIS/HER hearing shortly. I will notify you when the hearing is scheduled and advise you of any further developments.

HO5--R/H Assigned to ALJ--Hearing Scheduled

I have notified *CLMT NAME that *HIS/HER hearing has been scheduled for *DATE at *TIME. After the hearing, I will proceed with a decision on the case and inform you of any further developments.

HO6--Claimant Failed to Show for Hearing

Although *HE/SHE was informed that *HIS/HER hearing was scheduled for *DATE at *TIME, *CLMT NAME did not show up for the hearing. I have sent *HIM/HER a notice requesting an explanation for *HIS/HER failure to appear and will notify you when more information is available.

HO7--Post-Hearing Development

After *CLMT NAME's hearing was held, I determined that additional evidence was needed in the case. When this information is received, I will proceed with the decision on the case. I will continue to inform you of any developments.

HO8--Decision Being Prepared

*CLMT NAME's hearing was held on *DATE, and a decision is now being prepared. I will notify you of the decision when it is released.

Decision/Order Paragraphs

HOF1--Untimely Dismissal

I have issued an order dismissing *CLMT NAME's request for hearing because * HE/SHE did not file the request within 60 days of receipt of the reconsideration notice, as required by the Social Security Regulations. If * HE/SHE wishes to pursue the case further, *CLMT NAME may file a request for review by the Appeals Council within 60 days of receipt of the dismissal order. * CLMT NAME may file a request for review at any local Social Security office, at a hearing office, or by writing directly to the Appeals Council.

HOF2--Failure to Show Dismissal

I have issued a dismissal order in *CLMT NAME's case because *HE/SHE did not come to the hearing and did not provide a valid reason for not appearing. If * HE/SHE wishes to pursue the case further, *CLMT NAME may file a request for review by the Appeals Council within 60 days of receipt of the dismissal order. * CLMT NAME may file a request for review at any local Social Security office, at a hearing office, or by writing directly to the Appeals Council.

HOF3--Res Judicata Dismissal

I have issued an order dismissing *CLMT NAME's request for hearing because the facts and issues presented in the current application are the same as those covered by a previous application. Because no new and material evidence was presented, I dismissed the case.

If *HE/SHE wishes to pursue the case further, *CLMT NAME may file a request for review by the Appeals Council within 60 days of receipt of the dismissal order. * CLMT NAME may file a request for review at any local Social Security office, at a hearing office, or by writing directly to the Appeals Council.

HOF4--Unfavorable Decision

After careful consideration of *CLMT NAME's case, I issued an unfavorable decision.

If *HE/SHE wishes to pursue the case further, *CLMT NAME may file a request for review by the Appeals Council within 60 days of receipt of the decision. * CLMT NAME may file a request for review at any local Social Security office, at a hearing office, or by writing directly to the Appeals Council. If *HE/SHE does not file an appeal, my decision will stand as the final decision of the Secretary in this case.

 

HOF5--Partially Favorable Decision

After carefully considering *CLMT NAME's case, I have issued a partially favorable decision.

If *HE/SHE wishes to pursue the case further, *CLMT NAME may file a request for review by the Appeals Council within 60 days of receipt of the decision. * CLMT NAME may file a request for review at any local Social Security office, at a hearing office, or by writing directly to the Appeals Council. If *HE/SHE does not file an appeal, my decision will stand as the final decision of the Secretary in this case.

HOF6--Favorable Decision

I am pleased to inform you that I have issued a favorable decision in *CLMT NAME's case. * HIS/HER file has been sent to the *OFFICE for processing of payment.

With the decision, *CLMT NAME was also advised that the Appeals Council in Falls Church, Virginia, has 60 days from the date of the decision to review it. If the Council decides to review the case, *CLMT NAME will be notified promptly.

Closing Paragraphs

HOC1--HO Call-Back

If you have further questions about this case, please contact this office at *PHONE #.

HOC2--HO/AC Call-Back

If you have further questions about this case, please contact the hearing office at *PHONE # or the Appeals Council at (703) 305-0290.

Signature Blocks

HOS1--CALJ Signature

Sincerely yours,

HOCALJ Name

Hearing Office Chief Administrative Law Judge

HOS2--ALJ Signature

Sincerely yours,

ALJ Name

Administrative Law Judge


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