DI 33001: Introduction
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
TN 6 (09-17)
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 his or her 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,
andare 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 |
Request for Change in Time/Place of Disability Hearing |
|
Notice Regarding Substitution of Party Upon Death of Claimant-Reconsideration of Disability Cessation |
|
Waiver of Right to Appear-Disability Hearing |
|
Request for Reconsideration-Disability Cessation Right to Appear |
|
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 |