PRIA, Government Policy, Made Personal

Summary

Requires the Social Security Commissioner to decide the facts and rights of anyone applying for these payments and to give a fair notice and a chance for a hearing to anyone who says they qualify and disagrees with a decision, if they ask for a hearing within 60 days after getting the notice. At a hearing the Commissioner must look at the evidence and can confirm, change, or reverse the earlier decision. The Commissioner may also start hearings or investigations on their own. During hearings the Commissioner can swear witnesses, question them, and accept evidence even if a court would not allow it. The Commissioner must consider any physical, mental, educational, or language limits (including lack of English) when deciding whether someone acted in good faith, was at fault, or intended fraud. If someone misses the deadline to ask for review, that alone will not stop them from filing a new application later if they can show they failed to ask in good faith because they relied on wrong, incomplete, or misleading information given by an SSA officer or employee. Any notice of a denial that can be reviewed must clearly explain how reapplying instead of asking for review could affect possible benefits. Final decisions after a hearing can be taken to court under the same rules as other Social Security decisions (see section 405(g)).

Title 42, §1009

The Public Health and Welfare, Source: USLM XML via OLRC

(a)Hearings

(1)In general

The Commissioner of Social Security shall make findings of fact and decisions as to the rights of any individual applying for payment under this subchapter. The Commissioner of Social Security shall provide reasonable notice and opportunity for a hearing to any individual who is or claims to be a qualified individual and is in disagreement with any determination under this subchapter with respect to entitlement to, or the amount of, benefits under this subchapter, if the individual requests a hearing on the matter in disagreement within 60 days after notice of the determination is received, and, if a hearing is held, shall, on the basis of evidence adduced at the hearing affirm, modify, or reverse the Commissioner of Social Security’s findings of fact and the decision. The Commissioner of Social Security may, on the Commissioner of Social Security’s own motion, hold such hearings and conduct such investigations and other proceedings as the Commissioner of Social Security deems necessary or proper for the administration of this subchapter. In the course of any hearing, investigation, or other proceeding, the Commissioner may administer oaths and affirmations, examine witnesses, and receive evidence. Evidence may be received at any hearing before the Commissioner of Social Security even though inadmissible under the rules of evidence applicable to court procedure. The Commissioner of Social Security shall specifically take into account any physical, mental, educational, or linguistic limitation of the individual (including any lack of facility with the English language) in determining, with respect to the entitlement of the individual for benefits under this subchapter, whether the individual acted in good faith or was at fault, and in determining fraud, deception, or intent.

(2)Effect of failure to timely request review

A failure to timely request review of an initial adverse determination with respect to an application for any payment under this subchapter or an adverse determination on reconsideration of such an initial determination shall not serve as a basis for denial of a subsequent application for any payment under this subchapter if the applicant demonstrates that the applicant failed to so request such a review acting in good faith reliance upon incorrect, incomplete, or misleading information, relating to the consequences of reapplying for payments in lieu of seeking review of an adverse determination, provided by any officer or employee of the Social Security Administration.

(3)Notice requirements

In any notice of an adverse determination with respect to which a review may be requested under paragraph (1), the Commissioner of Social Security shall describe in clear and specific language the effect on possible entitlement to benefits under this subchapter of choosing to reapply in lieu of requesting review of the determination.

(b)Judicial review

The final determination of the Commissioner of Social Security after a hearing under subsection (a)(1) shall be subject to judicial review as provided in section 405(g) of this title to the same extent as the Commissioner of Social Security’s final determinations under section 405 of this title.

§1009 Hearings and Review

Summary

Title 42, §1009

Notes & Related Subsidiaries

Editorial Notes

Prior Provisions

Prior Provisions

Citations & Metadata