Five Customer Satisfaction Survey - Mail Surveys - Statistical

Hearing Process Report Card Survey – Award - English

Social Security is continually working to improve the service we provide the public. Please complete this questionnaire to give us your opinion of the service you received when you requested a hearing on your application for disability benefits.
MARKING INSTRUCTIONS Correct Marking Example: 
Use blue or black pen or a number 2 pencil. Do not use pens with ink that soaks through the paper.			Make no stray marks. Keep all entries within the boxes.
Please use the scale shown to rate the following aspects of your hearing experience. Mark [X] ONE answer for every item. If a question does not apply to you, please mark Not Applicable.
		Excellent		Very Good		Good	Fair	Poor	Very Poor	Not Applicable
When you decided to request a hearing…
1. Ease of finding information about how to file your hearing request										
2. Quality of information you got from Social Security explaining the hearing process										
While you were waiting for your hearing to be held…
3. Ease of contacting Social Security about your hearing request										
4. Helpfulness of the information Social Security gave you about your hearing request										
How your hearing was held…
5. Did you have a representative, either an attorney or some other person, handle your hearing? Mark only ONE answer.
	Yes
	No
6. Did you have a hearing with a judge face-to-face or by video conference? Mark only ONE answer.
	Hearing was face-to-face with a judge. Please continue with question 7
	Hearing was by video conference with a judge.Please continue with question 7
	No hearing was held with a judge. Please continue with question 14
Please use the scale shown to rate the following aspects of your hearing experience. Mark [X] ONE answer for every item.		Excellent		Very Good		Good	Fair	Poor	Very Poor	Not Applicable
When your hearing was held…
7. Location of the office where your hearing was held										
8. How well the judge explained what would happen at your hearing										
9. How prepared the judge was to talk about the facts of your case										
10. Opportunity the judge gave you or your representative to present the facts of your case										
11. Courtesy of the judge										
Waiting for the hearing and decision…
12. Length of time from the date you first requested your hearing until it was held										
13. Length of time from the date your hearing was held until you received the decision										
14. Overall length of time from the date you first requested your hearing until you received the decision										
Notice of Social Security’s decision on your hearing…
15. How well the notice explained the decision on your hearing										
16. How well the notice explained the amount of your benefits and when they would start										
Your overall experience with Social Security…
17. Helpfulness of the staff										
18. Courtesy of the staff										
19. How well the staff knew their jobs										
20. Overall experience with the hearing on your disability application										
21. Overall opinion of Social Security’s service										
22. Please use the space below to tell us anything else about the service you received in connection with your hearing.

Social Security is continually working to improve the service we provide the public. Please complete this questionnaire to give us your opinion of the service you received when you requested a hearing on your application for disability benefits.
MARKING INSTRUCTIONS Correct Marking Example: 
Use blue or black pen or a number 2 pencil. Do not use pens with ink that soaks through the paper.			Make no stray marks. Keep all entries within the boxes.
Please use the scale shown to rate the following aspects of your hearing experience. Mark [X] ONE answer for every item. If a question does not apply to you, please mark Not Applicable.
		Excellent		Very Good		Good	Fair	Poor	Very Poor	Not Applicable
When you decided to request a hearing…
1. Ease of finding information about how to file your hearing request										
2. Quality of information you got from Social Security explaining the hearing process										
While you were waiting for your hearing to be held…
3. Ease of contacting Social Security about your hearing request										
4. Helpfulness of the information Social Security gave you about your hearing request										
How your hearing was held…
5. Did you have a representative, either an attorney or some other person, handle your hearing? Mark only ONE answer.
	Yes
	No
6. Did you have a hearing with a judge face-to-face or by video conference? Mark only ONE answer.
	Hearing was face-to-face with a judge. Please continue with question 7
	Hearing was by video conference with a judge.Please continue with question 7
	No hearing was held with a judge. Please continue with question 14
Please use the scale shown to rate the following aspects of your hearing experience. Mark [X] ONE answer for every item.		Excellent		Very Good		Good	Fair	Poor	Very Poor	Not Applicable
When your hearing was held…
7. Location of the office where your hearing was held										
8. How well the judge explained what would happen at your hearing										
9. How prepared the judge was to talk about the facts of your case										
10. Opportunity the judge gave you or your representative to present the facts of your case										
11. Courtesy of the judge										
Waiting for the hearing and decision…
12. Length of time from the date you first requested your hearing until it was held										
13. Length of time from the date your hearing was held until you received the decision										
14. Overall length of time from the date you first requested your hearing until you received the decision										
Notice of Social Security’s decision on your hearing…
15. How well the notice explained the decision on your hearing										
16. How well the notice explained what to do if you disagreed with the decision										
Your overall experience with Social Security…
17. Helpfulness of the staff										
18. Courtesy of the staff										
19. How well the staff knew their jobs										
20. Overall experience with the hearing on your disability application										
21. Overall opinion of Social Security’s service										
22. Please use the space below to tell us anything else about the service you received in connection with your hearing.

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