COVID Screener Questionnaire

IMPORTANT: COVID-19 PROCEDURES

PLEASE READ BEFORE YOUR HEARING DATE

Due to the COVID 19 pandemic, you must follow the health and safety guidelines below when you come to our office for your scheduled hearing.

Please read the information below to prepare for your visit to our hearing office.

Before the Hearing

• Please review the COVID-19 health-screening checklist located at www.ssa.gov/appeals/hearing_inperson.html. If you do not have access to the internet, please call your local hearing office at the telephone number at the top of this notice for an explanation of the self-screening questions. Please call the office right away if you answer yes to any of the health screening questions.

NOTE:  The COVID-19 health-screening checklist must be completed no more than 24 hours before your scheduled hearing.

• If you want to review your file before your hearing, you must call the hearing office at the number at the top of this notice to make arrangements.

• Please be on time for your hearing, but please do not arrive more than 15 minutes before your hearing time. We are limiting the number of people who can be in our public reception areas. Therefore, we may ask you to wait outside until others leave the office.  

• Generally, only you and your appointed representative, if you have one, may enter the office. If you need another person with you including a witness to provide evidence or information that supports your case, please call the hearing office at the number shown at the top of this notice to make arrangements.

• Please note that representative/claimant rooms are not available.

• You may be asked to wear a face mask while in our office including during the hearing. If you are unable to wear a face mask, please contact our office right away to make alternate arrangements for your hearing.

On the Day of the Hearing

• Be sure you do not have any COVID-19 symptoms and call the number at the top of this notice right away if you do.

• During the COVID-19 pandemic, we are limiting the number of people who can be in our public reception areas. Therefore, please be prepared to wait outside the office.  

• Be prepared to wear a face mask throughout your visit.

• Adhere to signage requiring physical distancing.

What to Expect During the Hearing

• Because we are limiting the number of people in each hearing room, generally only the Administrative Law Judge, you and your appointed representative, if you have one, will be in the hearing room during the hearing. Any other hearing participants may participate by telephone.

• We are taking steps to protect hearing participants from COVID-19. For example, you may be seated behind a plastic barrier in the hearing room.