DI 42010: Effectuating ALJ, AC, and Court Decisions (Single Appellant, Single Issue) Sections
TN 6 (10-15)
The Social Security Administration (SSA) must pay monthly Federal benefits prospectively if the Commissioner does not make a final decision within 110 calendar days after the date of the administrative law judge (ALJ) decision. These interim benefits start the month before the month in which the 110th day falls and end the month before the month the Commissioner issues a final decision.
A. There is no interim benefits start order
The notice to a claimant about the Appeals Council’s review of a favorable ALJ decision tells the claimant that we will pay interim benefits effective with the month before the month in which the 110th day falls. The claimant may contact SSA as the 110th day approaches to inquire about interim benefits. If the processing center (PC) had not received the start order for Title II interim benefits, request a start order to initiate interim benefits by sending an email to:
^DCARO OAO 8001
Or, if needed, send a fax to: Office of Appellate Operations (OAO)(703) 605-7201
B. Final ALJ or AC decision not issued within nine months
Interim benefit payments require close management to prevent payment beyond the month of final decision. Because of the sensitivity of this workload, please follow the OAO development guidelines in this section.
The procedures in this section apply if the case is pending an AC decision or was remanded back to the ALJ for a decision. Therefore, PC staff and management should carefully evaluate which office to contact.
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If |
then |
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The claimant is still in interim benefit payment status for nine months |
The PC will query the Case Processing & Management System (CPMS) to see if the case is pending with the AC or is pending in the Hearing Office (HO). If the case is pending with the AC: The PC will email OAO at ^DCARO OAO 8001 and inquire about the status of the claim pending. OAO will provide status via fax or email if the case is pending with the AC. Establish diary to recontact OAO in three months and return the case to the holding file for the next followup. If the case is pending in an HO: The PC will email the hearing office director (HOD) and inquire about the status of the claim pending. Use the HO staff listing at: http://odar.ba.ssa.gov/hq-components/ocalj/field-staff-listings/ to obtain the name of the HOD. The HOD will provide status via telephone or email if the case is pending with the HO. Establish diary to recontact the HO in three months and return the case to the holding file for the next followup. |
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The claimant is still in interim benefit payment status for 12 months |
The PC will query CPMS to verify whether the case is pending with the AC or HO. If the case is pending with the AC The PC will write a memorandum to the executive director of OAO requesting OAO to expedite the case and inform him or her that interim benefit payments continued for 12 months without a final decision. Include any special characteristics of the case. The module manager will forward the memorandum via email to ^DCARO OAO and return the case to the holding file for the next followup. If the case is pending in an HO The PC will write a memorandum to the director of the Division of Field Procedures (DFP) requesting DFP expedite the case and inform him or her that interim benefit payments continued for 12 months without a final decision. Include any special characteristics of the case. The module manager will forward the memorandum via email to |||ODAR OCALJ DFP and return the case to the holding file for the next followup. |
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The claimant is still in interim benefit payment status for 15 months |
The PC will query CPMS to verify whether the case is pending with the AC or HO. If the case is pending with the AC The PC will send an email with subject line “URGENT-SECOND NOTIFICATION” to ^DCARO OAO and inquire about the status of the claim pending decision. OAO will provide status via telephone or email. Return the case to the holding file for the next followup. If the case is pending with the HO The PC will send an email with subject line “URGENT-SECOND NOTIFICATION” to |||ODAR OCALJ DFP and inquire about the status of the claim pending. The DFP will provide status via telephone or email. Return the case to the holding file for the next followup. |
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The claimant is still in interim benefit payment status for more than 16 months |
Refer the issue to the PC’s Operation Support Branch with a summary of the facts and a copy of the original memorandum. The OSB Chief will forward the original memorandum written to the executive director of OAO or director of the DFP to the Office of the Deputy Commissioner, Office of Analytics, Review, and Oversight (OARO) via email and request the case be expedited. Inform the Deputy Commissioner that interim benefit payments have continued for more than 16 months without a final decision. Include any previous correspondence with OAO OR OHO (if available) or special characteristics of the case. Return the case to the holding file pending a reply. |