[Federal Register Volume 65, Number 110 (Wednesday, June 7, 2000)]
[Notices]
[Pages 36210-36213]
From the Federal Register Online via the Government Publishing Office [www.gpo.gov]
[FR Doc No: 00-14216]


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SOCIAL SECURITY ADMINISTRATION


Administrative Review Process, Test of the Elimination of the 
Fourth Step of Administrative Review in the Disability Claim Process 
(Request for Review by the Appeals Council) in Conjunction With Testing 
of Modifications to the Disability Determination Procedures; Disability 
Claims Process Redesign Prototype

AGENCY: Social Security Administration.

ACTION: Notice of a test.

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SUMMARY: The Social Security Administration (SSA) is announcing a test 
of the elimination of the fourth step of administrative review in the 
disability claim process (Request for Review by the Appeals Council) in 
conjunction with the present disability prototype test. Before making 
any decisions on the merits of the elimination of the request for 
review, SSA must obtain valid and reliable data on the effects of such 
elimination--including the impact it may have on agency operations, 
notices and other procedures, rates of filing to Federal District 
Courts, and quality and timeliness of service to the public.

DATES: Cases to be included in the test of the elimination of the 
Request for Review will be selected from those prototype case requests 
for hearing which are received in servicing hearing offices on or after 
June 1, 2000, or the date of this notice--whichever is later; and in 
which an initial application for Social Security Disability Insurance 
or Supplemental Security Income Disability Benefits was filed effective

[[Page 36211]]

between and including January 1, 2000 and July 31, 2000.

FOR FURTHER INFORMATION CONTACT: Georgia E. Myers, Regulations Officer, 
Office of Process and Innovation Management, Social Security 
Administration, L2109 West Low Rise, 6401 Security Boulevard, 
Baltimore, MD 21235-6401, (410) 965-3632 or TTY 410-966-5609 for 
information about this notice. For information on eligibility or filing 
for benefits, call our national toll-free number, 1-800-772-1213 or TTY 
1-800-325-0778.

SUPPLEMENTARY INFORMATION: Current rules codified at 20 CFR 404.966 and 
416.966 authorize us to test procedures for eliminating the request for 
Appeals Council Review (``Request for Review Eliminated''--RRE) on 
randomly selected cases. Additional rules codified at 20 CFR 404.906 
and 20 CFR 416.1406 authorize us to test other modifications to the 
disability determination procedures individually or in any combination. 
One test has already been conducted using the former authority and 
several tests have already been conducted using the latter. In fact, 
the sole test using the authority for elimination of request for 
Appeals Council Review was combined with a test using the authority to 
test modifications to the disability determination procedures 
individually or in any combination that we termed the full process 
model (FPM).
    The FPM was an integrated test (authorized in part under 404.906 
and 416.1406) that we initiated on April 7, 1997 (published in the 
Federal Register on April 4, 1997 (62 FR 16210)) that combined several 
modifications to the disability determination process including 
enhanced decision making authority for Disability Determination 
Services (DDS) disability examiners and a restructuring of the role of 
the DDS medical consultant; provision for a predecision interview 
conducted by the decision maker if the evidence is insufficient to 
support a fully favorable disability determination; and elimination of 
the reconsideration step of review for initial disability claims. It 
also included testing of the use of an adjudication officer for cases 
in which a request for hearing was filed. The test of the adjudication 
officer is authorized under rules at 20 CFR 404.943 and 416.1443.
    As an adjunct to the FPM test, using regulatory authority at 20 CFR 
404.966 and 416.1466 (published in the Federal Register on September 
23, 1997 (62 FR 49598)) we tested the RRE in order to assess the 
effects of this change, in conjunction with the other FPM 
modifications. We are now announcing a retest of the RRE (``RRE II'') 
because initial RRE study results failed to produce sufficient data 
upon which to base policy decisions and because testing the RRE in 
conjunction with recently implemented initiatives would yield valuable 
data for assessing the effects of the RRE upon claimant service and 
administrative processes.

Initial Level Prototype Testing

    The latest test using the regulatory authority at 20 CFR 404.906 
and 20 CFR 416.1406 was announced in the Federal Register on August 30, 
1999 (64 FR 47218). There we announced a prototype that incorporates 
multiple modifications to the disability determination procedures 
employed by State Disability Determination Services (DDSs) which have 
been shown to be effective in earlier tests. Specifically, the 
prototype incorporates a series of changes that improve the initial 
disability determination process by: providing greater decisional 
authority to the disability examiner and more effective use of the 
expertise of the medical consultant; ensuring development and 
explanation of key issues; increasing opportunities for claimant 
interaction with the decision maker before a determination is made; and 
simplifying the appeals process by eliminating the reconsideration 
step. The test is focused on 10 states to enable us to further refine 
the process and learn more about potential operational impacts of the 
changes identified. This strategy should allow us to put the complete 
process together and ensure that the changes meet our goal of improved 
service to disability applicants.
    The prototype test is being conducted in 10 states. Eight include 
all Social Security and Supplemental Security Income disability 
applications:

Alabama

--Department of Education, Disability Determination Services, 2545 
Rocky Ridge Lane, Birmingham, AL 35216
--Department of Education, Disability Determination Services, 2000 Old 
Bayfont Drive, Mobile, AL 36652

Alaska

--Division of Vocational Rehabilitation, Disability Determination Unit, 
619 East Ship Creek Avenue, Suite 305, Anchorage, AK 99501

Colorado

--Department of Human Services, Division of Disability Determination, 
2530 South Parker Road, Suite 500, Aurora, CO 80014-1641

Louisiana

--Department of Social Services, Office of Family Support, Disability 
Determination Services, 5905 Florida Blvd. Suite 3, Baton Rouge, LA 
70806
--Department of Social Services, Office of Family Support, Disability 
Determination Services, 2920 Knight Street, Suite 232, Shreveport, LA 
71105
--Department of Social Services, Office of Family Support, Disability 
Determination Services, 3510 North Causeway Blvd., Metairie, LA 70002

Michigan

--Family Independence Agency, Disability Determination Services, 608 W. 
Allegan Street, Third Floor, Lansing, MI 48933
--Family Independence Agency, Disability Determination Services, MI 
Plaza Building, Tenth Floor, 1200 Sixth Street, Detroit, MI 48226
--Family Independence Agency, Disability Determination Services, 315 E. 
Front Street, Traverse City, MI 49684
--Family Independence Agency, Disability Determination Services, 151 
South Rose Street, Kalamazoo, MI 49007-4715

Missouri

--Division of Vocational Rehabilitation, Section of Disability 
Determinations, 1500B Southridge Drive, Jefferson City, MO 65109
--Division of Vocational Rehabilitation, Section of Disability 
Determinations, 1845 Borman Court, Suite 200, St. Louis, MO 63146
--Division of Vocational Rehabilitation, Section of Disability 
Determinations, 4040 Seven Hills Drive, Florissant, MO 63033
--Division of Vocational Rehabilitation, Section of Disability 
Determinations, 8500 East Bannister Road, Kansas City, MO 64134
--Division of Vocational Rehabilitation, Section of Disability 
Determinations, 3014 Blattner Drive, Cape Girardeau, MO 63701
--Division of Vocational Rehabilitation, Section of Disability 
Determinations, 2530 I South Campbell, Springfield, MO 65807

New Hampshire

--Division of Adult Learning and Rehabilitation, Disability 
Determination Services, State Dept. of Education Building JB, 78 
Regional Drive, Concord, NH 03301

Pennsylvania

--Bureau of Disability Determination, Room 200--Central Operations, 
1171

[[Page 36212]]

South Camerson Street, Harrisburg, PA 17104-2594
--Bureau of Disability Determination, 264 Highland Park Blvd., Wilkes-
Barre, PA 18702
--Bureau of Disability Determination, 351 Harvey Avenue, Greensburg, PA 
15605
    Two include only applicants whose disability claims are processed 
in designated Disability Determination Services (DDS) branches:

California

--Los Angeles North and West--Department of Social Services, Disability 
and Adult Programs Division, 3425 Wilshire Blvd., Suite 1500, Los 
Angeles, CA 90010

New York

--Brooklyn--New York State Department of Social Services, Division of 
Disability Determinations, 300 Cadman Plaza West, 13th floor, Brooklyn, 
NY 11201-2701
--Albany--New York State Department of Social Services, Division of 
Disability Determinations, 99 Washington Avenue, Room 1239, Albany, NY 
12260.

Administrative Appeals Process Improvements and Testing of the RRE 
Paired With Prototype Test

    Testing the use of an Adjudication Officer (AO) authorized under 20 
CFR 404.943 and 416.1443 is not included in the prototype.
    Along with the prototype changes, we are incorporating several 
initiatives to improve the hearings process, including administrative 
efficiencies designed to streamline case processing; structural changes 
in the management organization of hearings offices; improvements in 
automation and data collection; and implementation of a ``national 
workflow model'' that combines pre-hearing activities, a standardized 
pre-hearing conference, and processing-time benchmarks for various 
tasks. This initiative was announced in the Federal Register on August 
30, 1999 (64 FR 47218) as the Hearing Process Improvement (HPI) 
initiative.
    Additionally, since the announcement of the HPI initiative, we have 
undertaken an Appeals Council Process Improvement (ACPI) initiative. 
ACPI includes short range initiatives to reduce pending workloads and 
processing times and long-range improvements in structure and 
operations enabling high quality, timely, and efficient case 
processing. The short-range elements that already are being implemented 
and will be in place during this test include:
     ``Differential case management''--a systematic technique 
of differentiating cases for processing based on substantive issues in 
the case.
     Processing of appeals by Office of Appellate Operations 
managers and supervisors without prior examination by hearings and 
appeals analysts;
     Temporary use of attorneys from the Office of the General 
Counsel to augment staff in the Appeals Council;
     Expedited presentation of cases to adjudicators; and
     Temporary use of Administrative Law Judges as Acting 
Administrative Appeals Judges to enhance the adjudicatory and analytic 
strength of the Appeals Council in the short term.
    If appealed to the ALJ level, most, but not all, of the cases from 
the prototype sites will go to hearing offices (HOs) that are in the 
first phase of the HPI. Thus, they will be processed using the 
efficiencies such as the ``national workflow model'' mentioned above. 
The prototype process is effective in prototype sites for cases 
effectively filed October 1, 1999 or after, with the exception of 
Albany, New York which became operational on April 1, 2000.
    Under the existing regulatory authority authorizing us to test RRE 
at 20 CFR 404.966 and 416.1466 (published in the Federal Register on 
September 23, 1997 (62 FR 49598)) we intend to add to the previously 
announced prototypes a test of the effects of the RRE on prototype 
cases that could potentially reach the Appeals Council level, following 
an unfavorable ALJ decision, that meet the following criteria:
     Effective date of initial filing is between and including 
January 1 and July 31, 2000.
     Request for an ALJ hearing has been filed;
     Case is received in the servicing HO on or after June 1, 
2000 or the effective date of this notice whichever is later; and
     The servicing HO has implemented HPI (``HPI Phase One''). A case 
meeting the other criteria but whose servicing HO is not an HPI phase 
One Office will not be included.
    Cases meeting the criteria received at the following HOs will be 
included:

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                   DDSs                                  HOs
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Alabama...................................  Burger-Phillips Centre, 1910
                                             3rd Ave. North, Suite 100,
                                             Birmingham, AL 35203.
                                            Walnut St. Executive Center,
                                             205 S. Walnut St., Suite D,
                                             Florence, AL 35630.
                                            3605 Springhill Business
                                             Park, Mobile, AL 36608.
                                            3381 Atlanta Highway,
                                             Montgomery, AL 36109.
Alaska....................................  2101 4th Ave., Suite 900,
                                             Seattle, WA 98121.
California:
Los Angeles West/North....................  City National Bank Bldg.,
                                             606 S. Olive St., Suite
                                             1200, Los Angeles, CA
                                             90014.
                                            11000 Wilshire Blvd., Rm.
                                             8200, Los Angeles, CA
                                             90024.
                                            Grosvenor Plaza, 150 S. Los
                                             Robles Avenue, Suite 500,
                                             Pasadena, CA 91101.
                                            8345 Firestone Blvd., Second
                                             Floor, Downey, CA 90241.
Colorado..................................  1244 Speer Blvd., Suite 752,
                                             Denver, CO 80204.
Louisiana.................................  3403 Government St.,
                                             Alexandria, LA 71302.
                                            1515 Poydras St., Suite
                                             1600, New Orleans, LA
                                             70112.
                                            First Bank Center, 1
                                             Galleria, Suite 2000,
                                             Metairie, LA 70001.
                                            700 Louisiana Towers 401
                                             Edwards St., Shreveport, LA
                                             71101.
Michigan..................................  Patrick J. McNamara Federal
                                             Bldg., 477 Michigan Ave.,
                                             Room 430, Detroit, MI
                                             48226.
                                            605 N. Saginaw St., First
                                             Floor, Suite A, Flint, MI
                                             48502.
                                            15 Ionia St. S.W., Third
                                             Floor, Grand Rapids, MI
                                             49503.
                                            Everett Plaza, 3500 S. Cedar
                                             St, Suite 109, Lansing, MI
                                             48910.
                                            Crown Pointe, 25900
                                             Greenfield Rd., Room 430,
                                             Oak Park, MI 48237.
Missouri..................................  11475 Olde Cabin Rd., Creve
                                             Coeur, MO 63141.

[[Page 36213]]

 
                                            Old Post Office Bldg., 815
                                             Olive St., Rm. 220, St.
                                             Louis, MO 63101.
                                            901 E. St. Louis St., Suite
                                             210, Springfield, MO 65806.
New Hampshire.............................  Daniel Webster Hwy. North,
                                             207 Hooksett Rd.,
                                             Manchester, NH 03104.
New York--Brooklyn *......................  111 Livingston Street, 18th
                                             Floor, Brooklyn, NY 11201.
Pennsylvania..............................  8380 Old York Rd., Suite
                                             250, Elkins Park, PA 19027.
                                            Penn National Office Bldg.,
                                             2 N. 2nd St., 8th Floor,
                                             Harrisburg, PA 17101.
                                            334 Washington St., Suite
                                             200, Johnstown, PA 15901.
                                            1601 Market St., 9th Floor,
                                             Philadelphia, PA 19103.
                                            601 Grant St., Suite 500,
                                             Pittsburgh, PA 15219.
                                            7 N. Wilkes-Barre Blvd.,
                                             Suite 210, Wilkes-Barre, PA
                                             18702.
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* Prototype cases processed at New York--Albany will not be included in
  the test becasuse of Albany's later start date.

    As stated in the Federal Register of August 30, 1999 (64 FR 47218) 
it is estimated that annually on a national level approximately 20 
percent of applicants for disability benefits would potentially 
participate in the prototype. Since those applications covered under 
the provisions of this notice include just over half a year, we 
estimate that approximately 10-12% of applicants for disability 
benefits (effective filings between 1/1/00 and 7/31/00) would 
potentially participate in at least one aspect of the prototype. Based 
on past case experience, those actually included in the RRE II cohort 
would be well below 1 percent of the national applicant workload.
    Selection of test and control cases will be done on a random basis. 
For those selected as test cases, the right to request review by the 
Appeals Council will be eliminated and the right of the claimant to 
appeal, in the case of an unfavorable ALJ decision, will be directly to 
Federal District Court.
    Claimants who could potentially be included in this retest of the 
RRE will be supplied notice of their appeal rights.
    Case outcome and appeals information about both Request for Review 
Retained (RRR) (control) and RRE II (test) cases will be collected and 
analyzed. Before making any decisions on the merits of the RRE, SSA 
must obtain valid and reliable data on the effects of such 
elimination--including the impact it may have on agency operations, 
notices and other procedures, rates of filing to Federal District 
Courts, and quality and timeliness of service to the public.

    Dated: May 31, 2000.
Rita S. Geier,
Associate Commissioner for Hearings and Appeals.
[FR Doc. 00-14216 Filed 6-6-00; 8:45 am]
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