I-1-8-7.Review and Acknowledgement of Complaints

Last Update: 4/12/13 (Transmittal I-1-64)

A. Complaint Submitted to the Division of Quality Service (DQS)

For information relating to the definition of, and criteria for, a complaint, see HALLEX I-1-8-4. The instructions herein reference complaints that meet the definition and criteria. When DQS receives a complaint from a public individual, governmental entity, or Social Security Administration (SSA) personnel, DQS, will:

  • Enter the case in the ALJ Public Alleged Misconduct Complaints System database (“database”) to generate an ID number for the complaint;

  • Create a folder containing a copy of the initial record from the database, a copy of the complaint, and any documents DQS receives with the complaint; and

  • Assign the case to the appropriate staff for review, and send an acknowledgement unless acknowledgement was previously sent pursuant to HALLEX I-1-8-7 B.

1. Complaint Review Process

DQS will review all complaints that meet the requirements set forth in HALLEX I-1-8-4; however, DQS will not review claims against Administrative Law Judges (ALJs) who are no longer with SSA.

a. DQS Staff Role in the Complaint Review Process

DQS staff will perform a review that includes an examination of the complaint, an audit of the hearing recording(s), if available, and a review and analysis of the hearing decision or order, and any other relevant documentation.

NOTE:

If DQS does not have a hearing recording or other relevant documentation, and internal queries indicate that the information is with the Appeals Council (AC), a Hearing Office (HO) or a National Hearing Center (NHC), DQS will work with the appropriate component(s) to obtain the missing information. If a hearing record cannot be obtained, DQS staff will review a transcript of the hearing recording, if available. If the missing information cannot be obtained, DQS will annotate this fact in the database and proceed with its investigation.

DQS staff will then prepare a written summary of the allegations and the findings from its review. DQS staff also will provide a recommendation to DQS management as to whether any further action is necessary.

DQS staff will update the database to reflect the status of the review.

b. DQS Management Role in the Complaint Review Process

DQS management will review the staff-level summary and recommendation. DQS management also may conduct an initial review of a complaint and make a recommendation, without receiving a staff-level recommendation. When necessary, DQS management may request that DQS staff undertake further review of the complaint before making a decision in the matter.

If following review of the complaint, DQS management determines an investigation is unnecessary, then DQS will follow the procedures set forth in HALLEX I-1-8-10. If DQS management determines an investigation is necessary, then DQS will follow the procedures set forth in HALLEX I-1-8-13.

DQS management will update the database to reflect the status of the review.

2. Acknowledgement Process

Except as provided in HALLEX I-1-8-7 A.2.a. and I-1-8-7 B., DQS will prepare an acknowledgement letter of the complaint, generally within 60 calendar days from the date the complaint is received by SSA.

a. Allegations Referred by the AC

If DQS receives a complaint from the AC under HALLEX I-1-8-4, DQS will review the complaint as described in HALLEX I-1-8-7 A.1.; but will not send an acknowledgement letter to the complainant. See Social Security Ruling (SSR) 13-1p: Title II and XVI: Agency Processes for Addressing Allegations of Unfairness, Prejudice, Partiality, Bias, Misconduct, or Discrimination by Administrative Law Judges (ALJs).

b. Acknowledgement to Appropriate Individuals and Entities

If DQS receives a complaint from a public individual, governmental entity, or SSA personnel (other than the AC), DQS will acknowledge the complaint in the following manner:

  • If the complainant is a claimant or representative, DQS will send the acknowledgement letter to the claimant and representative, if represented.

  • If the complainant is a Member of Congress, DQS will send the acknowledgement letter to the complainant. If requested by the Member of Congress, DQS will also send an acknowledgement letter to the claimant and representative, if represented, in the underlying case where the allegation of ALJ conduct arose.

  • If the complainant is any other governmental entity, DQS will acknowledge the complaint, if requested by the governmental entity. If requested by the referring governmental entity, DQS will also send an acknowledgement letter to the claimant and representative, if represented, in the underlying case where the allegation of ALJ conduct arose, referenced in HALLEX I-1-8-4.

  • If the complainant is SSA personnel (other than the AC), DQS will send the acknowledgement letter to the complainant, if requested. DQS will not send an acknowledgement letter to the claimant or representative on the underlying case where the allegation of ALJ conduct arose.

c. Content of the Acknowledgement Letter

DQS will prepare an appropriate acknowledgement letter, when applicable, based on which of these circumstances apply:

  • The claimant had a hearing but the ALJ has not issued a decision (Exhibit A);

  • The ALJ issued a decision but the appeal period has not expired (Exhibit B);

  • The claimant's appeal is currently pending at the AC (Exhibit C);

  • The ALJ issued a decision and the claimant did not timely appeal (Exhibit D);

  • The AC denied the claimant's request for review (Exhibit E); and

  • Additional information is required from the complainant (Exhibit F).

If the above-referenced circumstances are not applicable, then DQS will tailor an acknowledgement letter to the appropriate circumstances. If prior to sending the acknowledgement letter staff determined that an investigation is unnecessary, then the acknowledgement letter will also explain that DQS processed the complaint but the Privacy Act prevents disclosing whether it took any action against the ALJ who is the subject of the complaint. This letter will serve as the acknowledgement as well as the closeout required in HALLEX I-1-8-13 B.

B. Complaints Submitted to an Office of Disability Adjudication and Review (ODAR) Regional Office or the National Hearing Center (NHC) Central Office

If an ODAR Regional Office or the NHC Central Office receives a complaint from a public individual, governmental entity, or SSA personnel, the Regional Office or NHC Central Office will:

  • Prepare an acknowledgement letter to the complainant, generally within 60 calendar days from the receipt of the complaint, as set forth in HALLEX I-1-8-7 A.2.b., and using the templates set forth in HALLEX I-1-8-7 A.2.c.; and,

  • Forward a copy of the complaint, the acknowledgement letter, and any relevant documentation or hearing recording(s), not available electronically, to DQS for its processing under HALLEX I-1-8-7 A.

NOTE:

If possible, the Regional Office or NHC Central Office should send the documentation to DQS electronically. If that is not possible, the documentation should be mailed to the address for DQS contained in HALLEX I-1-8-4 A.4.

Exhibit A - The claimant had a hearing but the ALJ has not issued a decision

[Name of complainant]

[Address of complainant]

Re: Complaint against Administrative Law Judge (ALJ) _____

of the ____________ Hearing Office

Dear Mr. or Ms. _________:

Thank you for your letter/complaint dated ____________, concerning ALJ __________. You allege that ALJ _____ [short summary of allegations].

This office oversees complaints against the Social Security Administration's (SSA) administrative law judges (ALJs). However, our records indicate that a hearing was held in your/the claimant's case on [date]. We cannot take any action on your complaint at this time because no ALJ decision has been issued in your/the claimant's case. If you/the claimant disagree(s) with the decision once it is issued, you/the claimant may ask the Appeals Council to review it. The Appeals Council will address your/the claimant's concerns in its notice. The procedure for filing an appeal is explained in the letter you/the claimant will receive with your/the claimant's decision.

We expect our ALJs to conduct themselves in a professional manner. Once a decision is issued, appropriate SSA officials will look into your allegations. Please be aware that this office does not have the authority to alter an ALJ's decision. We cannot change the outcome of your/the claimant's case, but we will investigate your concerns and take suitable action, if warranted.

Thank you for bringing this matter to our attention.

Sincerely,

Exhibit B - The ALJ issued a decision but the appeal period has not expired.

[Name of complainant]

[Address of complainant]

Re: Complaint against Administrative Law Judge (ALJ) _____
of the ____________ Hearing Office

Dear Mr. or Ms. _________:

Thank you for your letter/complaint dated ____________, concerning ALJ __________. You allege that ALJ _____ [short summary of allegations].

This office oversees complaints against the Social Security Administration's (SSA) administrative law judges (ALJs) Our records indicate that ALJ _____ issued a decision in your/the claimant's case on [date] and that you/the claimant are/is still within the period that you/the claimant can file an appeal. If you/the claimant disagree(s) with the decision and have not yet filed an appeal, you/the claimant may wish to do so. You/The claimant may ask the Appeals Council to review the decision. The Appeals Council will address your/the claimant's concerns in its notice. The procedure for filing an appeal is explained in the letter you/the claimant received with your/the claimant's decision.

We expect our ALJs to conduct themselves in a professional manner. Appropriate SSA officials will look into your allegations. Please be aware that this office does not have the authority to alter an ALJ's decision. We cannot change the outcome of your/the claimant's case, but we will investigate your concerns and take suitable action, if warranted.

Thank you for bringing this matter to our attention.

Sincerely,

Exhibit C - The claimant's appeal is currently pending at the Appeals Council

[Name of complainant]

[Address of complainant]

Re: Complaint against Administrative Law Judge (ALJ) _____

of the ____________ Hearing Office

Dear Mr. or Ms. _________:

Thank you for your letter/complaint dated ____________, concerning ALJ __________. You allege that ALJ _____ [short summary of allegations].

This office oversees complaints against the Social Security Administration's (SSA) administrative law judges (ALJs). Our records indicate that ALJ _____ issued a decision in your/the claimant's case on [date] and that you/the claimant filed a request for review on [date]. Your/the claimant's complaint regarding ALJ ______'s actions at the hearing will be referred to the Appeals Council for processing since your/the claimant's case is pending there. Your concerns regarding ALJ _____'s decision will be addressed in the Appeals Council's notice that will be mailed to you/the claimant.

We expect our ALJs to conduct themselves in a professional manner. In addition to referring your/the claimant's allegations to the Appeals Council for review, appropriate SSA officials will look into your allegations regarding ALJ ______. Please be aware that this office does not have the authority to alter an ALJ's decision. We cannot change the outcome of your/the claimant's case, but we will investigate your concerns and take suitable action, if warranted.

Thank you for bringing this matter to our attention.

Sincerely,

Exhibit D - The ALJ issued a decision and the claimant did not timely appeal

[Name of complainant]

[Address of complainant]

Re: Complaint against Administrative Law Judge (ALJ) _____

of the ____________ Hearing Office

Dear Mr. or Ms. _________:

Thank you for your letter/complaint dated ____________, concerning ALJ __________. You allege that ALJ _____ [short summary of allegations].

This office oversees complaints against the Social Security Administration's (SSA) administrative law judges (ALJs). Our records indicate that ALJ _____ issued a decision in your/the claimant's case on [date]. Although you/the claimant were/was dissatisfied with the decision in your/the claimant's case, you/the claimant did not appeal it. The time for filing such an appeal has expired.

We expect our ALJs to conduct themselves in a professional manner. Appropriate SSA officials will look into your allegations. Please be aware that this office does not have the authority to alter an ALJ's decision. We cannot change the outcome of your/the claimant's case, but we will investigate your concerns and take suitable action, if warranted.

Thank you for bringing this matter to our attention.

Sincerely,

Exhibit E - The Appeals Council (AC) denied the claimant's request for review

[Name of complainant]

[Address of complainant]

Re: Complaint against Administrative Law Judge (ALJ) _____
of the ____________ Hearing Office

Dear Mr. or Ms. _________:

Thank you for your letter/complaint dated ____________, concerning ALJ __________. You allege that ALJ _____ [short summary of allegations].

This office oversees complaints against the Social Security Administration's (SSA) administrative law judges (ALJs). Our records indicate that ALJ _____ issued a decision in your/the claimant's case on ________ [date], and that you/the claimant filed a request for review on ___ [date]. On ____ [date], the Appeals Council denied your/the claimant's request for review.

We expect our ALJs to conduct themselves in a professional manner. Appropriate SSA officials will look into your allegations. Please be aware that this office does not have the authority to alter an ALJ's decision. We cannot change the outcome of your/the claimant's case, but we will investigate your concerns and take suitable action, if warranted.

Thank you for bringing this matter to our attention.

Sincerely,

Exhibit F - Additional information is required from the complainant

[Name of complainant]

[Address of complainant]

Re: Complaint against Administrative Law Judge (ALJ) _____
of the ____________ Hearing Office

Dear Mr. or Ms. _________:

Thank you for your letter/complaint dated ____________, concerning ALJ __________. You allege that ALJ _____ [short summary of allegations]. However, in your letter, you did not allege specific behavior on the part of the judge that was unprofessional.

This office oversees complaints against the Social Security Administration's (SSA) administrative law judges (ALJs). Our records indicate that ALJ _____ issued a decision in your/the claimant's case on ________ [date], and that you/the claimant filed a request for review on ___ [date]. [If applicable – You were dissatisfied with the decision in your case and timely filed a request for review with the Appeals Council. If applicable – Although you were dissatisfied with the decision in your case, you did not file an appeal.] This office does not have authority to alter a judge's decision. We cannot change the outcome of the ALJ's decision in your case.

We expect our ALJs to conduct themselves in a professional manner. If you have evidence of specific allegations about inappropriate or biased treatment or other misconduct by the ALJ, please forward this additional information for our review within 30 days of the date of this letter. We will not investigate your allegations unless we receive this additional information.

Sincerely,