I-2-4-99.Exhibit -- Case Processing When a Claimant Moves Into or Out of a Prototype State During the Appeals Process

Last Update: 7/22/05 (Transmittal I-2-59)

Claimant moves...

To...

Then the appeal level is a...

After the initial disability determination, but before appeal, from a:

   

Prototype DDS

another Prototype DDS

hearing

Prototype DDS

a non-Prototype DDS

reconsideration*

non-Prototype DDS

a Prototype DDS

reconsideration, because the claimant did not have the benefit of a Claimant Conference

After the initial disability determination and after requesting appeal (reconsideration), i.e., from a non-Prototype DDS

Prototype DDS

reconsideration

After the initial disability determination and after requesting appeal (hearing), from a:

   

Prototype DDS

another Prototype DDS

hearing

Prototype

a non-Prototype DDS

hearing

* regardless of any Prototype notice with appeal rights to a hearing

Example 1

A claimant in the Prototype requests an appeal (hearing) of the initial disability determination prior to moving to a non-Prototype State. Moving to a non-Prototype State drops the case from the process to the current process; however, because the claimant is already at the hearing level before the case drops out, the claim will not revert back to the reconsideration level, but will remain at the hearing level.

Example 2

A claimant in the Prototype receives an unfavorable disability determination and then moves to a non-Prototype State where she contacts the FO about filing an appeal. Moving to a non-Prototype State drops her case from the Prototype and, because she moved to the non-Prototype State before requesting appeal, the proper appeal on her claim is reconsideration, regardless of the fact that she received a notice stating her appeal rights were to a hearing.