SSA uses the information we obtain on Forms HA-55, HA-504, HA 504 OP1, HA-510, and HA-510-OP1 to manage the means by which we conduct hearings before an administrative law judge (judge) or administrative appeals judges (judge), and the scheduling of hearings with an judge. We use the HA-55, Objection to Appearing by Video Teleconferencing, and its accompanying cover letter, HA-L2, to allow claimants to opt-out of an appearance via video teleconferencing (VTC) for their hearing with a judge. The HA-L2 explains the good cause stipulation for opting out of VTC if the claimant misses the window to submit the HA-55, and for verifying a new residence address if the claimant moved since submitting their initial hearing request. SSA uses the HA-504 and HA-504-OP1, Acknowledgement of Receipt (Notice of Hearing), and accompanying cover letter, HA-L83, to: (1) acknowledge the claimants will appear for their hearing with a judge; (2) establish the time and place of the hearing; and (3) remind claimants to gather evidence in support of their claims. The only difference between the two versions of the HA-504 is the language used for the selection check boxes as determined by the type of appearance for the hearing (in person, phone teleconference, or VTC). In addition, the cover letter, HA-L83, explains: (1) the claimantsâ need to notify SSA of their wish to object to the time and place set for the hearing; (2) the good cause stipulation for missing the deadline for objecting to the time and place of the hearing; and (3) how the claimants can submit, in writing, any additional evidence they would like the judge to consider, or any objections they have on their claims. The HA-510 and HA-510-OP1, Waiver of Written Notice of Hearing, allow the claimants to waive their right to receive the Notice of Hearing as specified in the HA-L83. We typically use these forms when there is a last minute available opening on an judgeâs schedule, so the claimants can fill in the available time slot. If the claimants agree to fill the time slot, we ask them to waive their right to receive the Notice of Hearing. We use the HA-510-OP1 at the beginning of our process for representatives and claimants who wish to waive the 20 day (for amended or continued hearing notices) or 75 day (for all other hearing notices) requirement earlier in the process, and the HA-510 later in the process for those representatives and claimants who want the full 20 or 75 days before the scheduled hearing. The respondents are applicants for Social Security disability payments who request a hearing to appeal an unfavorable entitlement or eligibility determination or their representative payees.
US Code:
42 USC 405
Name of Law: Social Security Act
US Code:
42 USC 1383
Name of Law: Social Security Act
On behalf of this Federal agency, I certify that the collection of information encompassed by this request complies with 5 CFR 1320.9 and the related provisions of 5 CFR 1320.8(b)(3).
The following is a summary of the topics, regarding the proposed collection of information, that the certification covers:
(i) Why the information is being collected;
(ii) Use of information;
(iii) Burden estimate;
(iv) Nature of response (voluntary, required for a benefit, or mandatory);
(v) Nature and extent of confidentiality; and
(vi) Need to display currently valid OMB control number;
If you are unable to certify compliance with any of these provisions, identify the item by leaving the box unchecked and explain the reason in the Supporting Statement.
Form HA-504 Acknowledgement of Receipt (Notice of Hearing) - HA-504 (with teleconferencing)
Addendum - 0671.docx
Acknowledgement of Receipt (Notice of Hearing) - HA-504 (with teleconferencing)