SSR 19-3p: Titles II and XVI: Requesting Reconsideration or Hearing by an Administrative Law Judge

Effective Date: August 14, 2019 Federal Register,

vol. 84, No. 157, page 40467.

POLICY INTERPRETATION RULING

Purpose: The purpose of this SSR is to explain

the two options available to claimants appealing our determinations that

they are not disabled based on medical factors. This SSR explains both

the paper and electronic options for requesting reconsideration or a

hearing by an ALJ, and the similarities and differences between these two

options. In order to request reconsideration or a hearing using iAppeals,

our electronic appeal option, claimants must submit all of the information

we need to process their appeals at the time they file their electronic

appeals. This requirement is part of our streamlined electronic appeal

procedures. Claimants also can upload and simultaneously submit evidence

with their electronic appeals. After claimants have filed their appeals,

they can submit evidence by fax, by mail, or in-person at one of our

field offices or hearing offices as appropriate.

A claimant has an ongoing duty to inform us

about or submit all known evidence that relates to whether or not

he or she is blind or disabled. [1] An appointed representative must act with

reasonable promptness to help obtain the information and evidence

the claimant must submit, and forward the information or evidence

to us as soon as practicable. [2] When a claim is at the hearing level, the

claimant, or representative, generally must inform us about or submit

all written evidence no later than five business days before the

date of the scheduled hearing. [3] Our paper appeal procedures remain

unchanged—a claimant still must timely request his or her appeal

in writing, but may separately submit the additional information we need

to process the appeal. Through this SSR, we are providing information

that enables claimants to make informed decisions when deciding whether

to use iAppeals or the paper appeal option to request reconsideration

or a hearing.

paper appeal procedures remain

unchanged—a claimant still must timely request his or her appeal

in writing, but may separately submit the additional information we need

to process the appeal. Through this SSR, we are providing information

that enables claimants to make informed decisions when deciding whether

to use iAppeals or the paper appeal option to request reconsideration

or a hearing.

Citations: Sections 205(a) and (b) of the Social Security Act, as amended; 20 CFR 404.907 , 404.909 , 404.929 , 404.933 , 416.1407 , 416.1409 , 416.1429 , 416.1433 .

Introduction: Claimants who are dissatisfied with the

determinations or decisions on their disability applications may request

further review under our administrative review process, also known as

our appeal process. [4] The administrative review process consists of three

levels: reconsideration, hearing, and Appeals Council review. Until recent

years, the only way for claimants to request an appeal was to use the

paper-based option, which consists of paper appeal forms. As part of our

efforts to offer alternative service delivery options to the public, we

developed an electronic appeals system, which we call iAppeals. [5] After we

implemented the iAppeals process, we received some questions about it,

and how it differed from the traditional, paper-based process. This

SSR explains the differences between the paper and electronic appeal

procedures for filing a request for reconsideration or a hearing. [6] Claimants have the option of filing a request for reconsideration or a

hearing using either the paper-based option or iAppeals.

ed the iAppeals process, we received some questions about it,

and how it differed from the traditional, paper-based process. This

SSR explains the differences between the paper and electronic appeal

procedures for filing a request for reconsideration or a hearing. [6] Claimants have the option of filing a request for reconsideration or a

hearing using either the paper-based option or iAppeals.

Policy Interpretation: The Act states that a

claimant may request an appeal by making “a showing in writing.” [7] Our regulations provide that a claimant who

seeks reconsideration or a hearing may do so by filing a “written

request” within 60 days after receiving notice of our determination. [8] These regulations give us the authority to establish mechanisms

by which a claimant can file the “written request” to appeal a

determination. Accordingly, we have determined that a claimant may file a

“written request” for appeal using either the paper-based

appeals process

or iAppeals. [9] While there are some differences between our paper and

electronic appeal options for filing a request for reconsideration or a

hearing, the substantive standards used to evaluate a claimant’s appeal

request remain the same regardless of which option the claimant chooses.

The Paper-Based Process for Requesting a Reconsideration

or a Hearing

A claimant may file a written request for

reconsideration or a hearing by either mail or in-person at one of

our field offices. While our rules do not require claimants to use

a specific form to request an appeal, the SSA-561 “Request for

Reconsideration” (OMB No. 0960-0622) and HA-501 “Request for

Hearing by Administrative Law Judge” (OMB No. 0960-0269) collect

basic information we need to process the appeal. The SSA-561 and HA-501

request specific identifying information, such as the claimant’s name,

Social Security number, date of birth, and contact information

a specific form to request an appeal, the SSA-561 “Request for

Reconsideration” (OMB No. 0960-0622) and HA-501 “Request for

Hearing by Administrative Law Judge” (OMB No. 0960-0269) collect

basic information we need to process the appeal. The SSA-561 and HA-501

request specific identifying information, such as the claimant’s name,

Social Security number, date of birth, and contact information. The forms

also request the name and contact information for any representative

helping the claimant with the appeal, as well as the reason the claimant

disagrees with the determination. The HA-501 includes space for the

claimant to identify sources who can provide additional evidence.

Generally, a claimant also completes and submits the SSA-3441-BK

“Disability Report—Appeal” (OMB No. 0960-0144) along

with the appeal request. The SSA-3441-BK collects updated information

relevant to a claimant’s appeal, including:

- The contact information of a friend or relative

with knowledge of the claimant’s medical condition;

- A description of any change to the claimant’s

medical condition and any new medical conditions;

- The contact information of and visit dates

to all health care providers, and type of treatments, and tests

received;

- The name of any medications (prescription or over-the-counter) that

the claimant is currently taking, the reasons for taking them, any side

effects, and the name of the doctor who recommended or prescribed the

medication; and

- A description of any change in daily activities,

work, and education.

The contact information of a friend or relative

with knowledge of the claimant’s medical condition;

A description of any change to the claimant’s

medical condition and any new medical conditions;

The contact information of and visit dates

to all health care providers, and type of treatments, and tests

received;

n; and

- A description of any change in daily activities,

work, and education.

The contact information of a friend or relative

with knowledge of the claimant’s medical condition;

A description of any change to the claimant’s

medical condition and any new medical conditions;

The contact information of and visit dates

to all health care providers, and type of treatments, and tests

received;

The name of any medications (prescription or over-the-counter) that

the claimant is currently taking, the reasons for taking them, any side

effects, and the name of the doctor who recommended or prescribed the

medication; and

A description of any change in daily activities,

work, and education.

While claimants do not have to submit the SSA-3441-BK at

the time they file their paper appeal requests, a delay in providing the

information requested on the SSA-3441-BK impedes our ability to process

and forward an appeal request to the Disability Determination Services

(DDS) for a reconsideration determination or to the Office of Hearings

Operations for a decision by an ALJ. If a claimant does not provide the

information requested on the SSA-3441-BK at the time he or she files the

appeal request, generally, we attempt to contact the claimant in order

to obtain the information before the DDS makes a determination or an

ALJ makes a decision. [10]

The iAppeals Process for Requesting Reconsideration or a

Hearing

fice of Hearings

Operations for a decision by an ALJ. If a claimant does not provide the

information requested on the SSA-3441-BK at the time he or she files the

appeal request, generally, we attempt to contact the claimant in order

to obtain the information before the DDS makes a determination or an

ALJ makes a decision. [10]

The iAppeals Process for Requesting Reconsideration or a

Hearing

A claimant may file a written request for

reconsideration or a hearing using iAppeals, our electronic appeal

option. [11] When we first introduced iAppeals in 2007, claimants could

submit the electronic disability report form, i3441, “Disability

Report—Appeal,” after filing the i561, “Request

for Reconsideration,” or i501, “Request for Hearing by

Administrative Law Judge.” In 2015, we streamlined iAppeals by

merging questions from the standard appeal request forms, i561 or i501,

and the disability report, i3441, form, so that all of the information

needed to process an appeal is collected and submitted at the same time.

Claimants who choose to use iAppeals to request an appeal must complete

the full electronic appeal application in order to file the appeal

electronically. Completing the full electronic appeal application requires

claimants to answer questions from both the standard appeal request

form and the disability report form. However, iAppeals offers several

flexibilities for claimants: permitting claimants to leave questions blank

if they are not applicable; allowing claimants to indicate that they need

additional time to collect specific evidence; and enabling claimants

to partially complete an electronic appeal application, save it, and

return to finish it later, so long as they return and submit the appeal

within the regulatory appeal period. Claimants must file their appeals,

whether using the paper or the electronic administrative appeals process,

within the 60-day appeal period. [12]

additional time to collect specific evidence; and enabling claimants

to partially complete an electronic appeal application, save it, and

return to finish it later, so long as they return and submit the appeal

within the regulatory appeal period. Claimants must file their appeals,

whether using the paper or the electronic administrative appeals process,

within the 60-day appeal period. [12]

To ensure that claimants understand

the requirements for using the electronic appeal procedures to request

reconsideration or a hearing, we have included the following aids in

the iAppeals screen path to assists them:

- Terms of Service (TOS) Screen – The TOS

provides information about the types of appeals that claimants can file

in iAppeals, information needed to complete an electronic appeal, and

the alternative option to file an appeal request by mail or in-person

at the local Social Security Office. The Acknowledgement portion of the

TOS requires the claimant or a third party on the claimant’s behalf to

acknowledge that he or she understands certain information, including: The electronic appeal must be completed and filed within the

60-day appeal period. The “Submit” button within the “Submit”

Tab must be selected to file the appeal request with the Social Security

Administration. How to submit evidence, both before and after the appeal is filed. When he or she can and cannot re-enter the iAppeals

application. How to ensure that the electronic appeal is properly

submitted. How to add additional information or change information that has

already been submitted.

within the “Submit”

Tab must be selected to file the appeal request with the Social Security

Administration. How to submit evidence, both before and after the appeal is filed. When he or she can and cannot re-enter the iAppeals

application. How to ensure that the electronic appeal is properly

submitted. How to add additional information or change information that has

already been submitted.

- Re-entry Number Screen—Claimants who choose not to complete their

electronic appeals in one session can use the re-entry number we provide

to return to iAppeals to complete and submit their appeals in subsequent

sessions. The re-entry number screen explains that the appeal has

not been completed or submitted and that claimants who choose to exit

iAppeals before completion must return to iAppeals in order to complete

and submit their appeals electronically.

- Submit Tab: Claimants will see the Submit Tab throughout the electronic

appeal application path. The Submit Tab remains available to select

until claimants complete and submit their electronic appeal. The Submit

Tab will not be available once the electronic appeal is submitted.

Terms of Service (TOS) Screen – The TOS

provides information about the types of appeals that claimants can file

in iAppeals, information needed to complete an electronic appeal, and

the alternative option to file an appeal request by mail or in-person

at the local Social Security Office. The Acknowledgement portion of the

TOS requires the claimant or a third party on the claimant’s behalf to

acknowledge that he or she understands certain information, including:

- The electronic appeal must be completed and filed within the

60-day appeal period.

- The “Submit” button within the “Submit”

Tab must be selected to file the appeal request with the Social Security

Administration.

- How to submit evidence, both before and after the appeal is filed.

- When he or she can and cannot re-enter the iAppeals

application.

stands certain information, including:

- The electronic appeal must be completed and filed within the

60-day appeal period.

- The “Submit” button within the “Submit”

Tab must be selected to file the appeal request with the Social Security

Administration.

- How to submit evidence, both before and after the appeal is filed.

- When he or she can and cannot re-enter the iAppeals

application.

- How to ensure that the electronic appeal is properly

submitted.

- How to add additional information or change information that has

already been submitted.

The electronic appeal must be completed and filed within the

60-day appeal period.

The “Submit” button within the “Submit”

Tab must be selected to file the appeal request with the Social Security

Administration.

How to submit evidence, both before and after the appeal is filed.

When he or she can and cannot re-enter the iAppeals

application.

How to ensure that the electronic appeal is properly

submitted.

How to add additional information or change information that has

already been submitted.

Re-entry Number Screen—Claimants who choose not to complete their

electronic appeals in one session can use the re-entry number we provide

to return to iAppeals to complete and submit their appeals in subsequent

sessions. The re-entry number screen explains that the appeal has

not been completed or submitted and that claimants who choose to exit

iAppeals before completion must return to iAppeals in order to complete

and submit their appeals electronically.

Submit Tab: Claimants will see the Submit Tab throughout the electronic

appeal application path. The Submit Tab remains available to select

until claimants complete and submit their electronic appeal. The Submit

Tab will not be available once the electronic appeal is submitted.

Conclusion

before completion must return to iAppeals in order to complete

and submit their appeals electronically.

Submit Tab: Claimants will see the Submit Tab throughout the electronic

appeal application path. The Submit Tab remains available to select

until claimants complete and submit their electronic appeal. The Submit

Tab will not be available once the electronic appeal is submitted.

Conclusion

iAppeals is an efficient and convenient self-service

option that allows claimants who are dissatisfied with our determination

to electronically complete and submit a request for reconsideration or a

hearing. The paper-based administrative appeals process remains available

for claimants who wish to use it. While the use of iAppeals promotes our

ability to process cases faster, it is the claimant’s choice whether to

use the paper or electronic administrative appeals process. Claimants can

obtain more information about iAppeals and our paper appeal process by

visiting our website www.ssa.gov. Claimants can find information about

the iAppeals user experience in our Program Operations Manual System

at https://secure.ssa.gov/apps10/poms.nsf/lnx/0203101125 .

[1] 20 CFR

404.1512 and 416.912

[2] 20

CFR 404.1740 (b)(1) and 416.1540(b)(1)

[3] 20 CFR 404.935 and 416.1435

[4] Section 205(b) of the Social Security Act (Act), 42 USC 405(b); 20 CFR 404.900 , 404.907 , 404.909 , 404.929 , 404.933 , 404.967 , 404.968 , 416.1400 , 416.1407 , 416.1409 , 416.1429 , 416.1433 , 416.1467 , 416.1468 .

See, e.g. , Program Operations Manual System (POMS) GN 03101.125

iAppeals—General and Title II Instructions; DI 81007.050 i3441

Disability Appeal—iAppeals; SI 04005.035 iAppeals—Title XVI.

[5] Social Security Ruling (SSR)

96-10p “Policy Interpretation Ruling Electronic Service

Delivery,” explains that our electronic service delivery initiatives

allow the public to conduct their business in ways that are convenient

for them and efficient for both them and us.

—General and Title II Instructions; DI 81007.050 i3441

Disability Appeal—iAppeals; SI 04005.035 iAppeals—Title XVI.

[5] Social Security Ruling (SSR)

96-10p “Policy Interpretation Ruling Electronic Service

Delivery,” explains that our electronic service delivery initiatives

allow the public to conduct their business in ways that are convenient

for them and efficient for both them and us.

[6] Claimants may request Appeals Council (AC) review of administrative

hearing decisions by using the HA-520 “Request for Review of Hearing

Decision/Order,” the electronic i520, or a separate written request filed

at one of our offices or by mail. The differences explained in this

SSR are between the paper and electronic requests for reconsideration

or a hearing and do not apply to the paper and electronic requests for

review by the AC because we do not need the same type of information

when processing requests for review by the AC.

[7] 42 USC 405(b)(1) and 1383(c)(1)

[8] 20 CFR 404.909 , 404.933 , 416.1409 , 416.1433

[9] “[T]echnologies allow the transfer of

information by other than traditional paper-based methods. SSA is adopting

a definition of writing which is consistent with modern legal usage and

includes electronic information transfer.” SSR 96-10p .

[10] POMS DI 12005.005—Processing a

Reconsideration Request for a Medically Denied Initial Disability

Claim; DI 12010.001—Request for Administrative Law Judge (ALJ)

Hearing; DI 12010.005—Development of Administrative Law Judge

(ALJ) Hearing Cases.

[11] Appointed representatives, as well as family and

friends, are permitted to use iAppeals to file appeals on behalf of a

claimant. An appointed representative seeking direct payment of his or

her fee for services performed on the claim has an affirmative duty

to use iAppeals. See 20 CFR 404.1713 , 404.1740 , 416.1513 , 416.1740 ;

77 FR 4653; POMS GN 03970.010B.4. This affirmative duty is only for the

appointed representative, not the claimant.

iends, are permitted to use iAppeals to file appeals on behalf of a

claimant. An appointed representative seeking direct payment of his or

her fee for services performed on the claim has an affirmative duty

to use iAppeals. See 20 CFR 404.1713 , 404.1740 , 416.1513 , 416.1740 ;

77 FR 4653; POMS GN 03970.010B.4. This affirmative duty is only for the

appointed representative, not the claimant.

[12] Claimants must complete and submit their appeals

within 60 days of receiving the notice of determination they are

appealing. Claimants who do not submit their appeals within the applicable

60-day period may request an extension of time. See 20 CFR 404.909 , 404.911 , 404.933 , 416.1409 , 416.1411 , 416.1433 .

Claimants may request an extension of time on paper or using iAppeals. If

a claimant files an untimely appeal via paper or using iAppeals, but does

not provide reasons for why the appeal is untimely, we will request a

good cause statement before determining whether to process or dismiss

the appeal. See POMS GN 03101.010A.2, GN 03101.020, SI 04005.012B,

SI 04005.015.

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