POMS Reference

DI 29001: General

TN 1 (03-16)

A. Component responsibilities

The following chart describes the responsibilities of various components in the disability hearing process at the reconsideration level:

Component

Responsibilities

Field Office (FO)

  • Assists individuals with filing a Form SSA-789-U4 (Request for Reconsideration - Disability Cessation Right to Appear), and obtains all necessary supporting forms. For more information on these forms, see DI 12026.020B;

  • Sends these documents with the folder to the disability determination services (DDS), or the component responsible for developing non-State cases;

  • Serves as remote hearing site in order to provide accessible disability hearings to individuals who do not live within a reasonable distance of a DHU; and

  • Effectuates favorable reconsidered decisions.

Disability Determination Services (DDS)

  • Assigns the case to a pre-hearing examiner, who fully develops the case and reviews it for completeness with respect to each relevant issue;

  • Issues fully favorable reconsideration CDR determination if evidence warrants; and

  • Prepares folder for disability hearing and routes it to the DHU when unable to make a fully favorable determination.

Disability Hearing Unit (DHU)/ Disability Hearing Officer (DHO)

  • Schedules and holds hearing unless individual waived his or her right to appear. (If an individual waives the right to appear at a hearing or fails to appear, the DHO issues a decision based on the evidence in file, including any additional evidence submitted.)

    NOTE: If an individual fails to appear, the DHO must follow appropriate policy, which may require rescheduling the hearing (mental impairment involved, or good cause for not appearing).

  • Completes the appropriate disability determination and transmittal form SSA-831-U3, SSA-832, or SSA-833;

  • Issues a decision via a notice of reconsideration which provides administrative law judge (ALJ) appeal rights and, when appropriate, rights to statutory benefit continuation.

Review Components

  • Reviews the DDS' fully favorable reconsideration determinations. (Such determinations are subject to quality assurance review and, in Title II cases, to pre-effectuation review.); and

  • Returns case to the DDS for corrective action if the review indicates that the evidence does not warrant a fully favorable determination.

    NOTE: When the review component returns a case to the DDS, the DDS completes any necessary additional development and either prepares a revised (fully favorable) determination and returns the case to the review component, or prepares the folder for a disability hearing and forwards it to the DHU.

Great Lakes Program Service Center (GLPSC)

  • Processes career railroad and dependent annuitant cases;

  • Handles Request for Reconsideration-Disability Cessation in a manner similar to DDS procedure;

  • Forwards case to the DHO in the appropriate regional office (RO) if a hearing is necessary;

  • Effectuates determinations rendered by GLPSC or a DHO in coordination with the Railroad Retirement Board; and

  • Routes folder(s) to proper component for maintenance.

Office of Earnings and International Operations (OEIO)

  • Processes foreign claims in a manner similar to that described for the DDS;

  • The International Disability Unit (IDU) has its own DHO. Assist is sometimes requested from the Regional Office when the IDU DHO has had previous involvement in a particular claim (e.g., quality review); and

  • Effectuates reconsidered decisions issued in the OEIO.

B. References

  • DI 12026.020 Field Office (FO) Responsibilities When Claimant Wants to Request a Reconsideration–Disability Hearing

  • DI 12095.171 SSA-795 Election Statement - Exhibits

  • DI 29005.020 GLPSC - Career Railroad and Railroad Annuitant Cases

  • DI 33010.001 Receipt and General Review of Claims Folder in the Disability Hearing Unit (DHU)

  • DI 43501.001 Processing Responsibilities for Foreign Claims