Objection to Appearing by Video Teleconferencing - HA-55

Acknowledgement of Receipt (Notice of Hearing)

HA-L2 - Revised Version

Objection to Appearing by Video Teleconferencing - HA-55

OMB: 0960-0671

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SOCIAL SECURITY ADMINISTRATION
Refer To: [Clmt SSN]
[Clmt Name]

Office of Disability Adjudication and Review
[Local Office Address]
Tel: [Local Office Phone]/ Fax: [Local office
Fax]
[Current Date]

 [OBO Name] on behalf of
[ClaimantFirstName][ClaimantLastName]
[OBO Address]

[ClaimantFirstName][ClaimantLastName]
[ClaimantAddress]

Dear  [OBO Name]  [Addressee] 

 The Appeals Council returned your case to us for further action. This letter
explains the hearing process and things that you should do now to get ready for your hearing.
 The United States District Court returned your case to us for further
action. This letter explains the hearing process and things that you should do now to get ready for
your hearing.  Thank you for your request for a hearing.  We will
mail a Notice of Hearing to you at least  75  20 60
75 days before the date of
your hearing to tell you its time and place. Although we will make every effort to schedule your
hearing as soon as possible, there may be a delay. If you wish to discuss the status of your case,
you may call us or write to us. Our telephone number and address are at the top of this page.
We are required by the district court opinion dated May 28, 1985 in Martinez, et al. v. Secretary
of HHS, E.D.N.Y., No. 73 Civ. 900, to notify you of procedures available to you in the event of
unreasonable delay in processing your case. If, after requesting the status of your case, you
believe your case is being delayed unreasonably, you may apply to the United States District
Court for relief, including interim benefits.

 The Appeals Council returned your case to us for further action. This letter
explains the hearing process and things that you should do now to get ready for your hearing. We
will send you a notice after we schedule your hearing. We will notify you at least  75
75 days before the date of your hearing. The notice will provide you with the
 20 60
time and place of your hearing. We generally process requests for hearing by date order, with

the oldest receiving priority. However, we expedite cases returned from the Appeals Council.
We will schedule your hearing as soon as we can, which may take several months.
 The United States District Court returned your case to us for further
action. This letter explains the hearing process and things that you should do now to get ready for
your hearing. We will send you a notice after we schedule your hearing. We will notify you at
75 days before the date of your hearing. The notice will
least  75  20 60
provide you with the time and place of your hearing. We generally process requests for hearing
by date order, with the oldest receiving priority. However, we expedite cases returned from the
Federal Courts. We will schedule your hearing as soon as we can, which may take several
months.
 Thank you for your request for a hearing before an administrative law
judge (ALJ). This letter explains the hearing process and things that you should do now to get
ready for your hearing. We will send you a notice after we schedule your hearing. We will notify
75 days before the date of your hearing. The notice
you at least  75  20 60
will provide you with the time and place of your hearing. We generally process requests for
hearing by date order, with the oldest receiving priority. We will schedule your hearing as soon
as we can, which may take several months.

Use of Video Teleconferencing (VTC) At Your Hearing
In certain situations, we hold your hearing by VTC rather than in person. We will let you know
ahead of time if we schedule your hearing by VTC.
If we schedule your appearance by VTC, you and the ALJ will be at different locations during
the hearing. A large, color monitor will enable you and the ALJ to see, hear, and speak to each
other. The ALJ will also be able to see, hear, and speak to anyone who comes with you to the
hearing. This may include your representative (if you have one), a friend, or a family member.
We will provide someone at your location to run the equipment and provide any other help you
may need.
You must let us know within 30 days after the date you receive this notice if you do not
want to appear at your hearing by VTC. (We may extend the 30-day period if you show you
had good cause for missing the deadline.) Please let us know by completing and returning the
attached form in the envelope we sent[if representative] your representative[else]
you[endif]. We will arrange for you to appear in person.
If you move before we hold your hearing, we retain the right to decide how you will appear at
your hearing, even if you objected to appearing by VTC. For us to consider your change of
residence when we schedule your hearing, you must submit evidence proving your new
residence.

Subsequent Application

Our records show that you have a prior application(s) pending at the Appeals Council. We
will not act on your current request for a hearing until the Appeals Council completes its
action on your prior application(s). The Appeals Council will complete its action as soon as
possible and send you a notice explaining the outcome.


If the Appeals Council denies or dismisses your request for review or makes a
partially favorable or unfavorable decision on your prior application(s), we will hold
a hearing on your current application(s). We will send you a Notice of Hearing at
75 days before the date of your hearing to tell you
least  75  20 60
its time and place.



If the Appeals Council decides to remand your prior application(s) for a new hearing,
we may combine your prior and current applications for the new hearing. We will
send you a Notice of Hearing at least  75  20 60
75 days before
the date of your hearing to tell you its time and place.



If the Appeals Council makes a favorable decision on your prior application(s) that
resolves all the issues in the current application(s), we will take no further action on
your new application(s).


The Hearing
At your hearing, you may present your case to the ALJ who will make the decision on
your claim(s). The ALJ will consider the issue(s) you raise, the evidence now in your file,
and any additional evidence you provide. The ALJ may also consider other issues,
including issues that were decided in your favor in the decision you appealed. The Notice
of Hearing will list the issues the ALJ plans to consider at the hearing.
Your hearing is the time to explain why you believe the ALJ should decide the issues in
your favor.
Your Right to An Interpreter At Your Hearing
You are not required to bring an interpreter. You must request an interpreter so we
can provide an interpreter free of charge. When you request an interpreter, tell us what
language you prefer (including ASL). An interpreter can be requested by calling our
office or sending a letter.

Your Right To Representation
You may choose to have a representative help you. We will work with this person just as
we would work with you. If you decide to have a representative, you should find one
quickly so that person can start preparing your case.

Many representatives charge a fee only if you receive benefits. Others may represent you
for free. Usually, your representative may not charge a fee unless we approve it. We are
enclosing a list of groups that can help you find a representative.
If you get a representative, you or that person must notify us in writing. You may use our
Form SSA 1696-U4 Appointment of Representative. Any local Social Security office
can give you this form.

Submitting Evidence
We need to make sure that your file has everything that the ALJ will need to decide your
case. After the ALJ reviews the evidence in your file, he or she may request more
evidence to consider at your hearing.
You are required to inform us about or submit all evidence known to you that relates to
whether or not you are blind or disabled. Your representative must help you
inform us about or submit the evidence, unless the evidence falls under an exception.
 You must inform us about or give us evidence no later than five
business days before the date of your hearing. The ALJ may choose to not consider the
evidence if you fail to provide it timely. Giving us evidence early can often help us
review your case sooner. If there is evidence you cannot give to us before the hearing,
you may bring it to the hearing.
We can help you get evidence. If you need help, contact our office, your local Social
Security office, or your representative (if you appoint one) immediately.
If a physician, expert, or other person is not providing documents important to your case,
you may ask the ALJ to issue a subpoena. A subpoena is a special document that requires
a person to submit documents or to testify at your hearing. The ALJ will issue a subpoena
only if he or she thinks the evidence is necessary to decide your case, and the evidence
cannot be obtained another way. You must ask the ALJ to issue a subpoena at least 10 5 days before your hearing date. Send your request in writing to
the address at the top of the first page of this letter.
You May See The Evidence In Your File
If you wish to see the evidence in your file, you can see it on or before the date of your
hearing. If you wish to see your file before the date of your hearing, please call us as soon
as you reasonably can at the number at the top of the first page of this letter.
If You Have Any Questions Or Your Address Changes
If you have any questions, please call or write us. You must tell us if you change your
address. For your convenience, we gave you our telephone number and address on the
first page of this letter.

Sincerely yours,

[Signee Name]
[Signee Title]
Enclosures:
Claimant’s copy (if Spanish notice is not selected)
HA-55 (Objection to Appearing by Video Teleconferencing)
SSA Publication No. 05-10075 (Your Right To Representation) if no rep
HA-L1 (Important Notice Regarding Representation) if no rep
HA-L4 (What Happens Next) if What Happens Next is checked
HA-827 (Medical Release Notice) if Med. Release Notice and Form is checked
SSA-827 (Authorization to Disclose Information to SSA) if Med. Release Notice and Form is
checked
SSA Publication No. 70-067 (Why You Should Have Your Hearing By Video)
Representative’s copy
Form HA-L2 (Request for Hearing Acknowledgement Letter - Spanish) if Spanish notice is
checked
HA-L4-SP (What Happens Next - Spanish) if Spanish notice is checked and What Happens Next
is checked
HA-L4 (What Happens Next) if What Happens Next is checked
Form SSA-L1697-U3 (Acknowledgement of Representation)
Form HA-L32 (Electronic Disability Claims Processing Insert) if fully electronic
HA-827 (Medical Release Notice) if Med. Release Notice and Form is checked
SSA-827 (Authorization to Disclose Information to SSA) if Med. Release Notice and Form is
checked
SSA Publication No. 70-067-SP (Why You Should Have Your Hearing By Video) if Spanish
notice is checked
Barcode Sheet if fully electronic


cc: [Rep First Name] [Rep Last Name]
[Rep Address]


Form HA-L2 (04-2015)


File Typeapplication/pdf
File TitleMicrosoft Word - Acknowledgement Letter.docx
Author177717
File Modified2016-11-23
File Created2016-07-12

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