The Social Security Administration (SSA) recently proposed regulation amendments to address the disposition of preexisting hearing requests following a partially favorable decision arising from a pre-hearing case review.
Background
Under current law, if a claimant requests a hearing before an Administrative Law Judge (ALJ), the SSA may conduct a pre-hearing case review under certain circumstances, such as where new evidence has been submitted or may be available, there is a change in the law, or there is an error in the file. If a fully favorable revised determination is issued, the ALJ will dismiss the hearing request unless a party requests within 30 days after the revised determination is mailed that a hearing take place. If a partially favorable revised determination is issued, the parties are notified that the hearing will proceed unless all parties agree to dismiss the hearing request. However, the current regulations do not specify how the claimant and others must notify the agency to request the dismissal. Additionally, by waiting 30 days before dismissing a hearing request when fully favorable decisions are issued, the SSA asserts that administrative resources are tied up.
Amendments designed to simplify process
The proposed amendments revise the process by which hearing requests are handled when a fully or partially favorable decision is issued as a result of a pre-hearing case review prior to the hearing. If a fully favorable revised determination is issued, an ALJ will dismiss a request for hearing soon after the fully favorable determination is issued, rather than waiting 30 days before dismissing the hearing request under current practice. All parties will have 60 days after the notice is received to request that the ALJ vacate the dismissal. If a partially favorable determination is made during the pre-hearing case review process, a hearing will be held unless a written dismissal request is received. If the SSA receives a written statement agreeing to a dismissal before the ALJ mails a notice of his or her decision, the agency will dismiss the request for a hearing.
If an attorney advisor issues a fully favorable decision, the SSA will treat this as a hearing level decision and will not hold a hearing unless a party requests within 60 days after receiving notice of the decision that an ALJ reinstate the request for a hearing. The 60-day deadline may be extended upon a showing of good cause for missing the deadline.
In addition to these changes, the SSA is proposing some technical language changes for greater clarity, including the changing of "wholly favorable" to "fully favorable."
The regulations affected by these amendments are located at 20 CFR ยงยง404.941, 404.042, 404.948, 404.960, 416.1441, 416.1442, 416.1448 and 416.1460.
Comments due by September 1, 2010
Comments on the proposed amendments must be submitted to one of the addresses specified in the notice of proposed rulemaking by September 1, 2010. The full text of the notice was published in the July 22, 2010, issue of the
Federal Register (75 Fed. Reg 42639).