GN 03102: Reconsideration (Title II and Entitlement Under Title XVIII)
TN 4 (12-06)
A. Policy
When a claimant’s appointed representative or representative payee, or other third party files a reconsideration on behalf of the claimant, we will notify the claimant at his/her last known address before we reconsider the initial determination. We will also provide the claimant with an opportunity to present any evidence which may be helpful to the reconsidered determination. Use the notice in NL 00703.474 as a sample to transmit the reconsideration determination to the claimant with a copy to the authorized representative, if appropriate. In the first paragraph refer to the person who made the request. Note on the transmittal letter to the claimant that a copy is being sent to the authorized representative. If anyone other than the claimant or authorized representative filed the appeal on behalf of the claimant, the notice of reconsideration determination goes to the claimant who may provide a copy to the individual who filed the appeal at his/her discretion.
NOTE: A claimant's appointment of a person as his/her representative must be in writing. The claimant must sign a written notice of appointment and file the notice with SSA. A notice of appointment is an SSA-1696-U4 (Appointment of Representative). Refer to GN 03910.040.
B. Procedure
1. Response to Inquiry from a Member of Congress (MC)
Ordinarily, a congressional inquiry is merely a request for information or an explanation. However, in some cases, the inquiry or the claimant’s letter (a copy of which may be enclosed with the congressional inquiry) constitutes an expressed or implied request for reconsideration. You will need to decide whether the inquiry constitutes an implied request based on the wording of the claimant’s letter. Resolve doubts in favor of finding it to be an implied request in which case, establish the reconsideration, and attach a copy of the congressional inquiry. Process the reconsideration and send the claimant the reconsideration determination. Explain that the reconsideration was requested on his/her behalf by the MC.
2. Notice to Member of Congress (MC)
a. If the Reconsidered Determination is the same as the Initial Determination
Give the MC a complete explanation separate from the claimant's.
b. If the Reconsidered Determination is Different from the Initial Determination
Explain in the letter to the MC how the changed determination affects the claimant in terms of the specific complaint.
Upon completion of the reconsideration, effectuate the determination by normal procedures.