SSR 78-15: Rescinded 1986

SSR 78-15

PURPOSE:

To set out a new policy with respect to title XVI reconsideration

requests related to the period of time within which a claimant can request

reconsideration of a title XVI initial determination.

CITATIONS:

Program Simplification Proposal dated May 19, 1975. House and Senate

Committee Reports regarding H.R. 10727 (Public Law (P.L.) 94-202).

Commissioner's testimony on September 19, 1975, before the Subcommittee on

Social Security of the Committee on Ways and Means. Action memorandum

dated November 21, 1975 (IDI-1), approved by the Commissioner on December

1, 1975. Regulations No. 16, section 416.1410.

PERTINENT HISTORY:

The period of time currently allowed for requesting a reconsideration of

a title XVI determination is 30 days from the date of receipt of notice of

the initial or revised determination. This administrative policy has been

in effect since the inception of the title XVI program, January 1, 1974.

(Regulations No. 16, Section 416.1410, Subpart N.)

The 30-day time frame for requesting reconsideration was established to

reflect a common approach with the 3-day period within which a claimant

may request a hearing as previously provided by statute (Section

1631(c)(1) of the Social Security Act).

The Social Security Administration (SSA) established a title II

administrative procedure of conforming the reconsideration time frame to

the hearing time frame in 1940 when the reconsideration step was provided

as an option to a hearing without forfeiting the claimant's right to a

hearing if the claimant wished to pursue an unfavorable reconsideration

determination. The time frames for the reconsideration and hearing were

more closely linked in 1959 when the reconsideration step was made

mandatory by regulations before the title II hearing would be authorized

e reconsideration step was provided

as an option to a hearing without forfeiting the claimant's right to a

hearing if the claimant wished to pursue an unfavorable reconsideration

determination. The time frames for the reconsideration and hearing were

more closely linked in 1959 when the reconsideration step was made

mandatory by regulations before the title II hearing would be authorized.

Since the law provided at least 6 months for a hearing to be requested, it

was necessary to protect the rights of a claimant who was required to go

through the intervening reconsideration step before a hearing would be

authorized. Therefore, if a claimant had been limited to less than 6

months (e.g., 3 months) within which to request reconsideration and

failing to file timely had been precluded from going on to the hearing

level (because of the mandatory reconsideration step) the claimant would,

in effect, have been deprived of his/her right to a hearing under the law

even though 6 months may not have elapsed since notification of the

determination. Therefore the time frame of 6 months as provided for title

II hearings became, in effect, an aggregate double 6-month period for the

two levels; i.e., reconsideration and hearing. This policy was

subsequently applied also by SSA to title XVIII and the black lung benefit

program. Furthermore, the title XVI appellate structure evolved from the

earlier title II pattern: the reconsideration time frame for title XVI

duplicated the statutory 30-day hearing time frame.

The enactment of P.L. 94-202 (January 2, 1976) makes the titles II, XVI,

XVII, and black lung part B appellate processes uniform and extends the

title XVI hearing time frame to 60 days from the date of receipt of the

notice of a determination. Therefore, the change from 30 days to 60 days

for a title XVI reconsideration will conform to the hearing time frame as

enacted.

ring time frame.

The enactment of P.L. 94-202 (January 2, 1976) makes the titles II, XVI,

XVII, and black lung part B appellate processes uniform and extends the

title XVI hearing time frame to 60 days from the date of receipt of the

notice of a determination. Therefore, the change from 30 days to 60 days

for a title XVI reconsideration will conform to the hearing time frame as

enacted.

The Commissioner indicated SSA was seeking a common time frame of 60 days

for the reconsideration and hearing level when he testified before the

House of Representatives Subcommittee on Social Security, Committee on

Ways and Means on September 19, 1975, and endorsed this position again

when he approved an action memorandum (IDI-1 dated November 21, 1975)

recommendation on this subject on December 1, 1975.

The House and Senate Committee Reports which describe the effects of H.R.

10727 refer to a common time frame of 60 days for the reconsideration and

hearing level. The text of the reports indicates that Congress intended

the legislative action of P.L. 94-202 to embrace both time frames even

though the reconsideration step of the appeals process is administrative

and not dealt with in the law.

The establishment of a common time frame for all levels of the appeals

process was included in the recommendations proposed by the Office of

Program Operations Legislative Task Force to Simplify Procedures in its

report of May 19, 1975.

The alleviation of public confusion as well as improvement in

administrative handling of appeals is expected by the implementation of

this policy. Additionally, the adoption of a uniform time frame for all

reconsideration will provide more efficient processing when an issue at

question is common to title II, XVI, and XIII. (The policy recommendation

to change the titles II, XVIII, and black lung part B reconsideration time

frame from 6 months to 60 days will be promulgated under separate cover.)

POLICY DIRECTIVE STATEMENT:

s policy. Additionally, the adoption of a uniform time frame for all

reconsideration will provide more efficient processing when an issue at

question is common to title II, XVI, and XIII. (The policy recommendation

to change the titles II, XVIII, and black lung part B reconsideration time

frame from 6 months to 60 days will be promulgated under separate cover.)

POLICY DIRECTIVE STATEMENT:

Reconsideration is a mandatory administrative appeals process and a

condition precedent to a hearing (except for appeals involving cessation

of blindness or disability due to medical improvement). A claimant (or the

claimant's representative) who is dissatisfied with an initial or revised

title XVI determination may request reconsideration of such determination

if the request is filed within 60 days (rather than 30 days) after receipt

of notice of such determination or the determination made by SSA will

become final. For purposes of effectuating administrative actions flowing

from an initial determination, the party shall be presumed to have

received the notice within 5 days from the date thereon, unless there is a

reasonable showing to the contrary.

CROSS REFERENCES:

Claims Manual section 13613.