Citations:

Social Security Act, section 205(b);

20 CFR 404.914-404.918, 404.992, 404.993, 416.1413b, 416.1414- 416.1418, 416.1492, 416.1493, and 422.140

TN 6 (09-17)

Citations:

Social Security Act, section 205(b);

20 CFR 404.914-404.918, 404.992, 404.993, 416.1413b, 416.1414-416.1418, 416.1492, , 416.1493, and 422.140

A. Introduction to the disability hearing process

1. Disability hearings and reopenings

This chapter addresses disability hearings at the reconsideration level of appeal. These procedures generally refer to reconsiderations of medical cessations, but they also include adverse reopening determinations.

2. Explanation of terms

When using these procedures, remember:

• the terms “Disability Hearing Officer (DHO) reconsidered determination” and the “DHO hearing decision” are synonymous;

• the term “Disability Hearing Unit (DHU)” means the separate adjudicatory Disability Determination Services (DDS) unit established for the purpose of processing disability hearing cases; and

• the terms “supervisory hearing officer (SHO)” and “DHO” refer to the DDS counterpart for these functions.

3. Availability of disability hearings

Disability hearings are available at the reconsideration level of appeal in:

• CDR medical cessation cases;

• CDR reopenings that change only the basis for the cessation;

• Adverse reopenings at the initial level (cases involving favorable initial CDR determinations which were reopened and revised to unfavorable or only partially favorable determinations) based on medical factors;

• Adverse reopenings of cases involving favorable reconsideration CDR determinations which were reopened and which we propose to adversely revise based on medical factors.

NOTE: For additional information about the claimant’s right to a disability hearing at the medical CDR reconsideration level, refer to DI 29001.001. For DHO reopening policy, refer to DI 33020.025.

B. Federal and State disability hearings

We conduct hearings at both State and Federal levels. If you need to modify these procedures to conform to State business processes, you cannot modify them in any manner that would conflict with the Federal regulations governing disability hearings.

A Federal DHO may conduct hearings where SSA made the determination under appeal, such as railroad and foreign claims. The Associate Commissioner for the Office of Disability Determinations, or his or her delegate, appoints Federal DHOs. There may be circumstances when a Federal DHO assists State DHUs.

C. Who may conduct a disability hearing

Experienced disability adjudicators who have completed Social Security Administration (SSA) DHO training may conduct disability hearings. These individuals:

• must have had no involvement in making the determination under appeal, i.e. the initial continuing disability review (CDR) cessation or adverse reopening, or the pre-hearing (PH) affirmation of the initial CDR cessation,
  and

• are part of an adjudicatory unit of a state agency or Federal component (DHU) other than the adjudicatory unit that made the determination under appeal (DDS).

D. List of forms commonly used in disability hearing cases