TN 7 (08-09)

A. Background for CDR ALJ appeal

Appeals of Continuing Disability Review (CDR) cessations to an Administrative Law Judge (ALJ) are no longer excluded from electronic folder case processing. If the CDR being appealed was processed in EDCS, process the hearing electronically as well. The Field Office (FO) continues to serve as the starting point for CDR Hearings. The Comparison Point Decision (CPD) folder for the hearing may be a paper folder or a certified electronic folder (CEF). If the CPD folder is paper, the paper folder must be sent to the Hearings Office (HO) when the eCDR hearing is transferred in EDCS. If the CPD folder is a CEF, it is linked to the appeal when the eCDR is transferred to the HO.

For further information regarding the creation of the Initial eCDR, see eCDR Short Term Process Overview – DI 81010.200.

B. FO responsibilities for eCDR hearings

A Disability Determination Services (DDS) Disability Hearings Officer (DHO) prepares a letter to advise the individual about the Disability Hearings Unit (DHU) determination. The individual may choose to appeal the determination. The individual contacts the FO to complete the necessary hearing forms with a Claims Representative (CR). In order to process the request, the CR:

• follows instructions in Request for Administrative Law Judge (ALJ) Hearing – DI 12010.001;

• reviews MBR, SSR, and DCF, etc.; and

• develops good cause for late filing per GN 03101.020 Good Cause for Extending the Time Limit to File an Appeal, if appropriate.

  REMINDER: Process requests for continuation of benefits per Processing Statutory Benefit Continuation (SBC) – DI 12027.010 and obtain an SSA-795 (Statement of Claimant or Other Person) signed by the claimant.

1. Completing eCDR hearings in EDCS

Process eCDR hearings in EDCS and view them in eView. To process the eCDR hearing, EDCS users must open EDCS and establish a record by completing the following actions:

• Select “CDR Hearing” from the Select Case Level screen;

• Select “OK” button;

• Enter the appeal filing date on the Confirm Case Creation screen;

• Select “Create Case” button;

  Key in the CDR information, the SSA-3367 (Disability Report-Field Office), and the SSA-3441 (Disability Report-Appeal) data in EDCS on the Form(s) Selection screen;

  NOTE: The “Copy from Prior” button in EDCS will be enabled if information is available to copy from prior level(s). For more information see Creating Electronic Disability Collect System (EDCS) Cases - DI 81010.020E.1.

• Enter the reason for the appeal and limited data similar to the eCDR Initial CDR including:

1. the SSN,

2. claim type,

3. name,

4. address,

5. attorney representative name and address, and

6. representative payee name and address;

REMINDER: Verify and update the appropriate address, telephone number, and representative information on the mainframe before transferring the hearing in EDCS.

• Obtain a paper HA-501 (Request for Hearing by Administrative Law Judge) or written statement signed by the claimant and one SSA-827 (Authorization to Disclose Information to the Social Security Administration (SSA)). Also obtain an SSA-3881 (Questionnaire for Children Claiming SSI Benefits) for SSI childhood disability claims. NOTE: Do not delay sending the eCDR hearing to the HO to obtain an SSA-3881 or an SSA-827;

• Fax the front and back of the HA-501 or written statement signed by the claimant into the CEF, then dispose of the form per instructions in Storing Non-Medical Evidence in the Certified Electronic Folder – DI 81010.135;

  NOTE: For SSI only appeals recorded in MSSICS, the FO may print the appeal request from MSSICS and fax a copy into the CEF. If one is provided, fax the SSA-827 to the CEF. For more detailed information about SSA-827 requirements for a hearing request, see Field Office Instructions for Obtaining Form SSA-827 - DI 11005.057.

• Fax a “good cause” for late filing statement signed by the claimant into the CEF when appropriate;

• Fax medical evidence submitted by the individual with the eCDR hearing request into the CEF per Faxing Documents into the Certified Electronic Folder (CEF) Using Barcodes – DI 81010.090;

• Fax any development regarding Statutory Benefit Continuation (SBC) (e.g. Report of Contact, SSA-795, and any other documentation per Statutory Benefit Continuation (SBC) – DI 12027.001 into the CEF. Dispose of the development per Storing Non-Medical Evidence in the Certified Electronic Folder – DI 81010.135; and

• Mail other forms (SSA-3881 and, SSA-821 (Work Activity Report-Employee), etc.) provided for the eCDR hearing to the HO. The HO scans the document into the CEF or sends the document to the contract scanner.

2. Systems inputs

The CR records essential control information in the system to document the appeal and any SBC information. For SBC system inputs, see Processing Statutory Benefit Continuation (SBC) – DI 12027.010C.

a. Title II

When recording the appeal information for Title II:

• Input appeal information in the Postentitlement Online System (POS). See POS Selection List (PESL) (MSOM T2PE 002.003) and Disability Cessation (PEC1) (MSOM T2PE 003.024).

• Enter representative information in the Appointed Representative Data Base (ARDB).

b. Title XVI

When recording the appeal information for Title XVI:

• Input appeal information in Modernized Supplemental Security Income Claim System (MSSICS). See MSOMS Appeals - Overview, MSOMS (MSOM MSSICS 020.001);

• Use MSSICS Direct Update SSR (DUSSR) to annotate Non-MSSICS cases;

  NOTE: Non-MSSICS cases are those cases never processed in MSSICS or where there is no active claim iteration on the MSSICS pending file. See MSOM Appeals Process (MSOM BUSSR 002.007).

• Enter representative information in MSSICS and ARDB.

3. Transferring the eCDR hearing in EDCS

When transferring the eCDR hearing:

• Review the claim to resolve any edits;

• Select the Transfer tab in EDCS;

• Answer “Yes” to the paper folder indicator (PFI) question if the CDR involves a paper CPD folder;

  NOTE: If the CPD is a CEF and is linked to the eCDR, the PFI will default to “No”.

• Select the claims to transfer and enter “OK”; and

• Update the DCF immediately after the EDCS transfer.

  NOTE: All eCDR hearing claims on the case must be transferred at the same time.

4. Routing the paper folder or documents

The EDCS routing form generates at the point of transfer. (The CR has the option to print or cancel print of the routing form.)

If a paper CPD folder was used to make the cessation determination:

• Place the SSA-827 and any other relevant documents including medical evidence submitted by the individual in the paper folder;

• Print and attach an EDCS routing form to the top of the folder; and

• Send the folder to the HO.

If the CPD folder is a CEF, attach the EDCS routing form to the SSA-827s and any other relevant documents including medical evidence submitted by the individual and mail them to the HO.

Do not print an EDCS routing form if there are no paper documents or forms (i.e. 827’s, SSA-795’s, etc.) being sent. For more information on routing SSA-827s, see Field Office Instructions for Obtaining Form SSA-827 – DI 11005.057.

5. FO processing of eCDR hearing decisions

When the FO receives an alert on the EDCS Claims Actions page notifying them of the HO decision on an eCDR appeal:

• Follow instructions in Action Following a Favorable Administrative Law Judge (ALJ) Hearing Decision – DI 12010.035 when the decision is favorable. (REMINDER: The HO forwards Title II favorable decisions to the Processing Center for effectuation.), or

• Follow instructions in Action Following an Unfavorable Administrative Law Judge (ALJ) Hearing Decision – DI 12010.045B when the decision is unfavorable.