TN 13 (08-96)

A. Policy

A waiver determination is an initial determination and, thus, subject to appeal. The type of appeal depends on whether waiver was approved or denied, whether reconsideration was also requested, and whether waiver was approved or denied after personal conference.

Appeal of an initial waiver determination provides the opportunity to present new evidence and to have an independent review of the facts. The initial waiver determination and/or any finding may be reversed based on new evidence.

NOTE: This applies to Title II cases only. Please see SI 02260.006.B.7. for Title XVI cases as the levels of appeal are different.

B. Levels of appeal based on an approved or denied waiver request

1. Level of Appeal — Waiver Approval

• If waiver was approved without a personal conference, reconsideration is the next level of appeal.

• If waiver was approved after a personal conference, an ALJ hearing is the next level of appeal.

2. Level of Appeal — Waiver Denial

• If the person declined a personal conference or failed to appear for a conference, reconsideration is the next level of appeal.

• If the personal conference was held, ALJ hearing is the next level of appeal.

3. Level of Appeal — Combined Waiver/Reconsideration

ALJ hearing is the next level of appeal.

NOTE: If the reconsideration request is filed more than 60-days after the determination, the Field Office (FO) should develop for good cause of late filing per instructions in GN 03101.020, before forwarding the request to the Processing Center (PC).

See MSOM DMS 006.003 for input instructions.

Appeal of an initial waiver determination provides the opportunity to present new evidence and to have an independent review of the facts. The initial waiver determination and/or any finding may be reversed based on new evidence.

NOTE:This applies to Title II cases only. Please see SI 02260.006.B.7. for Title XVI cases as the levels of appeal are different.