We are pleased to publish the newly reformatted Best Practices Handbook for claimants' representatives. It is our hope that all claimants' representatives will use this handbook as a practice aid when advocating and appearing before the Office of Disability Adjudication and Review.
The Office of Disability Adjudication and Review is one of the largest administrative adjudicatory systems in the world. The claimants who appear before us may feel overwhelmed by the legal and administrative requirements associated with pursuing a Social Security claim. Therefore, it is important for those most closely associated with this effort to work together in a collegial and professional manner to make this process as efficient as possible. It is to this end that we publish this handbook so that we can successfully fulfill our joint mission to provide the best possible service to the public.
Frank A. Cristaudo
Associate Chief Administrative Law Judge
Social Security Administration
Office of Disability Adjudication and Review
This is a general rule for all dealings with SSA. At the hearing level, the majority of claimants are represented, and we encourage our employees to cooperate as much as possible with requests for information or assistance from representatives. However, every personal contact with hearing office personnel precludes the employee from performing other responsibilities relating to other hearing requests. Every five minutes that is saved on individual claims converts to thousands of saved hours that can be devoted to processing other claims.
If applicable, obtain and submit withdrawals and waivers from prior representatives to avoid possible delay in payment.
You should participate in periodic group meetings with the Hearing Office Chief Administrative Law Judge and Hearing Office Director in the offices in which you practice. Open dialogue allows both representatives and hearing offices to exchange suggestions as to how to improve service in the local area.
This would help reduce duplication of effort by hearing offices when notices are sent to either individual.
If the hearing office needs to request information on short notice for a possible on-the-record (OTR) decision or a dire need review, or for any other reason, it is very helpful to have updated release forms already in the file.
This form deals solely with payment to the representative and contains personal information, including a representative's Social Security number. If a SSA-1695 is received at a hearing office, it is immediately forwarded to the SSA field office for processing. Submitting this form to the SSA field office initially would significantly reduce the time hearing office staff spends forwarding documentation, and reduce the likelihood that the form will either be lost or improperly associated with the claimant's file.
Under 20 CFR §§ 404.935 and 416.1435, claimants have an existing duty to submit additional evidence with a Request for Hearing or within 10 days of submitting the request. Therefore, we encourage all representatives to review the file and submit evidence as early in the hearing process as possible. Do not wait until the case is scheduled to submit evidence. ODAR is aggressively screening cases for potential "on the record" situations and updated evidence is helpful in identifying cases that may be reversed without the need for a hearing. At the same time, we also encourage representatives to be mindful of hearing office resources required to burn CDs, and ask that representatives not request excess copies of CDs.
This is a problematic and time consuming issue dealt with at the hearing level, and significantly delays preparation of cases for hearing. Hearing office staff often spend several hours on any given case sorting out duplicate evidence. The sooner a case is prepared and exhibited, the sooner the case can be scheduled.
Up to 200 pages at one time can be faxed into the electronic folder using the fax number and bar code supplied with the Acknowledgment of Hearing notice. However, we do recommend smaller submissions when possible (less than 30 pages), as smaller exhibits open more quickly. Early submission (more than 10 working days before hearing) allows hearing office personnel to exhibit the evidence and ensures that the claimant’s copy of the file includes a copy of all the evidence that has been received. It also gives the ALJ time to review all the evidence, and helps to ensure that all relevant evidence is timely provided to experts scheduled to appear at hearing.
This simple precaution would significantly reduce the time hearing offices spend contacting representatives and re-associating evidence with the appropriate file.
If you do not have a barcode for a particular case, please ask the hearing office to provide you with one. Bar codes may be photocopied and used more than once.
Submitting evidence with a cover letter and the dates of the evidence will assist hearing office staff in identifying duplicates and in exhibiting the records.
This does not provide sufficient time for hearing office staff to associate the evidence with the file, or provide the ALJ and experts adequate time to review the evidence.
This assists hearing office staff in reviewing the evidence for duplicates and in exhibiting the records.
Medical and non-medical documents should be submitted separately. Because these documents are included in different sections of the folder, it requires more time to separate documents if they are submitted together.
Submit with supporting evidence or direct attention to supporting evidence already in the file. Treating source statements can greatly assist an ALJ in assessing Step 3 of the sequential evaluation and the claimant's residual functional capacity.
Be sure to distinguish long term disability, vacation, or bonus pay which may appear as earnings after alleged onset.
If there has been a settlement, provide appropriate proof.
This assists an ALJ in preparing for the hearing.
OTR requests are not appropriate in every case, and should be requested only when a favorable outcome is supported by the evidence in the record.
OTR requests should include a concise summary at the beginning of the brief outlining the argument, followed by a more detailed explanation specifically directing the reviewer's attention to evidence supporting a favorable decision.
Onset issues are the most frequent reason an OTR request cannot be granted.
A CD of these templates is available from hearing office personnel.
Attorney adjudicators review and screen cases for an OTR. Currently, attorney adjudicators have the authority to issue a fully favorable decision OTR when it is warranted. If you are contacted by a hearing office attorney regarding substantial gainful activity or onset issues in a particular case, discuss the matter with the attorney to see if the issue can be resolved without the need of a hearing.
Notifying a hearing office of these circumstances can significantly expedite the processing of a case, if the allegation is supported. The criteria and reference links for critical case processing can be found in our provisions in HALLEX I-2-1-40 (Critical Cases).
If a dire need case can be awarded without the need of a hearing, this works to the advantage of the claimant and the hearing office.
There are many difficulties that arise when an individual who has requested a hearing is incarcerated. For example, if an in-person hearing must be conducted, there are varying rules and procedures depending on the facility in which the claimant is incarcerated. Some claimants are transferred after a hearing has been scheduled but before the hearing has been held. For these types of reasons, it is very important that the hearing office is apprised at all times of the status of an incarcerated claimant.
Be flexible with providing dates and times for hearings, and request postponements in writing in a timely fashion wherever possible. When you have already agreed to the time of a scheduled hearing, avoid requesting a postponement for a conflict that arises later.
Representatives should avoid keeping the child in the hearing room when it will disrupt the hearing process or is otherwise not appropriate.
This will assist the ALJ in reviewing the records and appropriately focus attention on the information supporting your arguments, resulting in the issuance of a timely decision.
Submitting fee documents within this time frame will have a significant impact on the time a representative waits for payment. This reduces the number of follow ups necessary to determine if a fee petition is going to be submitted, allowing the ALJ to act on the fee authorization at an earlier date. It reduces the likelihood that funds withheld for direct payment will be released to the claimant, and reduces the wait time if administrative review of an authorized fee is requested.
The request should be clearly stated at the beginning of your correspondence to facilitate support staff screening and action on your request.
For internal review and association purposes, submitting all evidence at the same time would be very helpful.
It is always a good practice to concisely focus your arguments for a reviewer. We recommend using 2,000 words or less if possible.
The record is already before the Appeals Council.
Include page numbers of exhibits.
You can verify that the Appeals Council has received the request through your local Social Security office, local hearing office or by calling our Congressional and Public Affairs Branch staff (1-703-605-8000) or our general inquiries staff at our toll-free telephone number (1-800-772-1213).
Requests for extension of time should explain how much additional time is needed and why the request should be granted.