Document
Request for Review of Hearing Decision/Order - Internet Version
ICR 202603-0960-006 · OMB 0960-0277 · Object 167331600.
Document Viewer [pdf]
Status: Original and derived artifacts are available for this document.
Download: pdf
Loading document viewer…
Document Metadata
| File Type | application/pdf |
|---|---|
| File Title | Request for Review of Hearing Decision/Order - Internet Version |
| Author | [email protected] |
| Last Modified By | Microsoft® Word 2013 |
| File Modified | 2026-05-07 |
| File Created | 2017-10-03 |
| Conversion State | complete |
Extracted Text
SCREEN PACKAGE DOCUMENT (SCREENSHOTS ONLY) OAO IAPPEALS NON-MEDICAL: INTERNET VERSION 1.1 Screen Package Document – OAO iAppeals Non-Medical: Internet Version 1.1 Table of Contents 1. Design Screen Package Document Version Information .................................................................................... 4 2. Initial Screen........................................................................................................................................................ 5 2.1. Getting Ready............................................................................................................................................... 5 3. Screening ............................................................................................................................................................. 8 4. Notice of Decision ............................................................................................................................................... 9 4.1. Notice of Decision - Yes ............................................................................................................................... 9 4.2. Notice of Decision - No .............................................................................................................................. 10 5. Who is Entering Appeal ..................................................................................................................................... 11 5.1. Who is Entering Appeal 1st Party ............................................................................................................... 11 5.2. Who is Entering Appeal 3rd Party ............................................................................................................... 12 5.3. Who is Entering Appeal 3rd Party – Appointed Representative................................................................ 13 5.4. Who is Entering Appeal 3rd Party – Preparer, Other than Appointed Representative.............................. 13 5.5. Who is Entering Appeal 3rd Party – Other Preparer .................................................................................. 14 6. Applicant Information ....................................................................................................................................... 15 6.1. Applicant Information 1st Party................................................................................................................. 15 6.2. Applicant Information 1st Party – Home Address is different from Mailing Address ................................ 16 6.3. Applicant Information 3rd Party ................................................................................................................. 17 6.4. Applicant Information 3rd Party – Home Address is different from Mailing Address ............................... 18 7. Representative Information .............................................................................................................................. 19 7.1. Representative Information 1st Party ........................................................................................................ 19 7.2. Preparer Information 3rd Party .................................................................................................................. 21 7.3. Representative Information 3rd Party ........................................................................................................ 22 8. Request for Review ........................................................................................................................................... 24 8.1. Request for Review 1st Party ...................................................................................................................... 24 8.2. Request for Review 3rd Party ..................................................................................................................... 27 9. Attach Files ........................................................................................................................................................ 28 9.1. Attach Files 1st Party .................................................................................................................................. 28 9.2. Attach Files 1st Party – If either “Yes, I have paper documents” OR “No, I don’t have any documents to submit” is selected, File Details panel is not shown. User is taken to Summary. ............................................ 28 9.3. Attach Files 1st Party – If either “Yes, I have documents in electronic format” OR “Yes, I have both electronic and paper documents” is selected, show File Details panel. .......................................................... 29 9.4. Attach Files 1st Party – File Added ............................................................................................................. 31 9.5. Attach Files 3rd Party .................................................................................................................................. 32 DCS/OITBS/OITEBS/DUEAA /UXG 2 Screen Package Document – OAO iAppeals Non-Medical: Internet Version 1.1 9.6. Attach Files 3rd Party – If either “Yes, paper documents” OR “No, no documents to submit” is selected, File Details panel is not shown. User is taken to Summary. ............................................................................. 32 9.7. Attach Files 3rd Party – If either “Yes, documents in electronic format” OR “Yes, both electronic and paper documents” is selected, show File Details panel. .................................................................................. 33 9.8. Attach Files 3rd Party – File Added ............................................................................................................. 34 10. Summary ......................................................................................................................................................... 35 10.1. Summary 1st Party .................................................................................................................................... 35 10.2. Summary 3rd Party ................................................................................................................................... 36 11. Confirmation ................................................................................................................................................... 37 11.1. Confirmation 1st Party .............................................................................................................................. 37 11.2. Confirmation 3rd Party – Preparer ........................................................................................................... 38 11.3. Confirmation 3rd Party – Appointed Representative ............................................................................... 39 12. Receipt ............................................................................................................................................................ 40 12.1. Receipt 1st Party ....................................................................................................................................... 40 12.2. Receipt 3rd Party ..................................................................................................................................... 41 13. Cover Sheet ..................................................................................................................................................... 42 13.1. Cover Sheet 1st Party................................................................................................................................ 42 13.2. Cover Sheet Popup 3rd Party .................................................................................................................... 43 14. Message Pages ................................................................................................................................................ 44 14.1. Message 010 - Authorization Failure ....................................................................................................... 44 14.2. Message 024 - Cookies Disabled .............................................................................................................. 44 14.3. Message 025 - Session Timeout............................................................................................................... 45 14.4. Message 027 - We are processing your request...................................................................................... 46 14.5. Message 028 - This service is not available at this time .......................................................................... 46 14.6. Message 030 - We are processing your request...................................................................................... 47 14.7. Message 045 - Service Hours ................................................................................................................... 47 14.8. Message 052 - SSN Blocked ..................................................................................................................... 48 14.9. Message 113 - Number of Attempts Limit............................................................................................... 48 14.10. Message 151 – Unable to Verify ZIP ...................................................................................................... 49 DCS/OITBS/OITEBS/DUEAA /UXG 3 Screen Package Document – OAO iAppeals Non-Medical: Internet Version 1.1 1. Design Screen Package Document Version Information The first release of this design Screen Package document as a project deliverable is numbered 1.0. Subsequent revisions are numbered 1.1, 1.2, 1.3, etc. Content revisions are listed below with corresponding page numbers. Version Number 1.0 (First Release) Date 08/16/2017 Content Revisions Page Number Revised by Primary Author and Contact: Michelle Moses-Yearwood Secondary Contacts: OAO iAppeals Non-Medical UX Team (Sheila Y. Lee, Elizabeth Solovyeva, Anne Gonnella, Robyn Chester) 1.1 (First Revision) 08/25/2017 Updated the wording on “Information You Need” page. 6 Updated wording on “Notice of Decision” page. 9, 10 Updated the “SSA Program Title” drop list. 25 Replaced screenshot for “Attach Files 1st Party” 28 Updated the “Document Type” drop down list. 30 Moved Help popup messages closer to their parent pages. 6, 7, 25, 26 Added screens for error messages 44-49 ES 1.2 (Second Revision) 1.3 (Third Revision) DCS/OITBS/OITEBS/DUEAA /UXG 4 Screen Package Document – OAO iAppeals Non-Medical: Internet Version 1.1 2. Initial Screen 2.1. Getting Ready DCS/OITBS/OITEBS/DUEAA /UXG 5 Screen Package Document – OAO iAppeals Non-Medical: Internet Version 1.1 2.1.1. Information You Need DCS/OITBS/OITEBS/DUEAA /UXG 6 Screen Package Document – OAO iAppeals Non-Medical: Internet Version 1.1 2.1.2. Appointed Representative DCS/OITBS/OITEBS/DUEAA /UXG 7 Screen Package Document – OAO iAppeals Non-Medical: Internet Version 1.1 3. Screening DCS/OITBS/OITEBS/DUEAA /UXG 8 Screen Package Document – OAO iAppeals Non-Medical: Internet Version 1.1 4. Notice of Decision 4.1. Notice of Decision - Yes DCS/OITBS/OITEBS/DUEAA /UXG 9 Screen Package Document – OAO iAppeals Non-Medical: Internet Version 1.1 4.2. Notice of Decision - No DCS/OITBS/OITEBS/DUEAA /UXG 10 Screen Package Document – OAO iAppeals Non-Medical: Internet Version 1.1 5. Who is Entering Appeal 5.1. Who is Entering Appeal 1st Party DCS/OITBS/OITEBS/DUEAA /UXG 11 Screen Package Document – OAO iAppeals Non-Medical: Internet Version 1.1 5.2. Who is Entering Appeal 3rd Party 5.2.1. Drop Down List “What is your relationship to Jane Doe?” DCS/OITBS/OITEBS/DUEAA /UXG 12 Screen Package Document – OAO iAppeals Non-Medical: Internet Version 1.1 5.3. Who is Entering Appeal 3rd Party – Appointed Representative 5.4. Who is Entering Appeal 3rd Party – Preparer, Other than Appointed Representative DCS/OITBS/OITEBS/DUEAA /UXG 13 Screen Package Document – OAO iAppeals Non-Medical: Internet Version 1.1 5.5. Who is Entering Appeal 3rd Party – Other Preparer DCS/OITBS/OITEBS/DUEAA /UXG 14 Screen Package Document – OAO iAppeals Non-Medical: Internet Version 1.1 6. Applicant Information 6.1. Applicant Information 1st Party DCS/OITBS/OITEBS/DUEAA /UXG 15 Screen Package Document – OAO iAppeals Non-Medical: Internet Version 1.1 6.2. Applicant Information 1st Party – Home Address is different from Mailing Address DCS/OITBS/OITEBS/DUEAA /UXG 16 Screen Package Document – OAO iAppeals Non-Medical: Internet Version 1.1 6.3. Applicant Information 3rd Party DCS/OITBS/OITEBS/DUEAA /UXG 17 Screen Package Document – OAO iAppeals Non-Medical: Internet Version 1.1 6.4. Applicant Information 3rd Party – Home Address is different from Mailing Address DCS/OITBS/OITEBS/DUEAA /UXG 18 Screen Package Document – OAO iAppeals Non-Medical: Internet Version 1.1 7. Representative Information 7.1. Representative Information 1st Party 7.1.1. Representative Information 1st Party – No DCS/OITBS/OITEBS/DUEAA /UXG 19 Screen Package Document – OAO iAppeals Non-Medical: Internet Version 1.1 7.1.2. Representative Information 1st Party – Yes, There Is a Representative DCS/OITBS/OITEBS/DUEAA /UXG 20 Screen Package Document – OAO iAppeals Non-Medical: Internet Version 1.1 7.2. Preparer Information 3rd Party DCS/OITBS/OITEBS/DUEAA /UXG 21 Screen Package Document – OAO iAppeals Non-Medical: Internet Version 1.1 7.3. Representative Information 3rd Party 7.3.1. Representative Information 3rd Party – No DCS/OITBS/OITEBS/DUEAA /UXG 22 Screen Package Document – OAO iAppeals Non-Medical: Internet Version 1.1 7.3.2. Representative Information 3rd Party – Yes, There Is a Representative DCS/OITBS/OITEBS/DUEAA /UXG 23 Screen Package Document – OAO iAppeals Non-Medical: Internet Version 1.1 8. Request for Review 8.1. Request for Review 1st Party DCS/OITBS/OITEBS/DUEAA /UXG 24 Screen Package Document – OAO iAppeals Non-Medical: Internet Version 1.1 8.1.1. Drop Down List “SSA Program Title” 8.1.2. Where to find this date DCS/OITBS/OITEBS/DUEAA /UXG 25 Screen Package Document – OAO iAppeals Non-Medical: Internet Version 1.1 8.1.3. Where to find the SSA program title 8.1.4. Extension of Time DCS/OITBS/OITEBS/DUEAA /UXG 26 Screen Package Document – OAO iAppeals Non-Medical: Internet Version 1.1 8.2. Request for Review 3rd Party DCS/OITBS/OITEBS/DUEAA /UXG 27 Screen Package Document – OAO iAppeals Non-Medical: Internet Version 1.1 9. Attach Files 9.1. Attach Files 1st Party 9.2. Attach Files 1st Party – If either “Yes, I have paper documents” OR “No, I don’t have any documents to submit” is selected, File Details panel is not shown. User is taken to Summary. DCS/OITBS/OITEBS/DUEAA /UXG 28 Screen Package Document – OAO iAppeals Non-Medical: Internet Version 1.1 9.3. Attach Files 1st Party – If either “Yes, I have documents in electronic format” OR “Yes, I have both electronic and paper documents” is selected, show File Details panel. DCS/OITBS/OITEBS/DUEAA /UXG 29 Screen Package Document – OAO iAppeals Non-Medical: Internet Version 1.1 9.3.1. Attach Document – File Details 9.3.2. Drop Down List “Document Type” DCS/OITBS/OITEBS/DUEAA /UXG 30 Screen Package Document – OAO iAppeals Non-Medical: Internet Version 1.1 9.4. Attach Files 1st Party – File Added DCS/OITBS/OITEBS/DUEAA /UXG 31 Screen Package Document – OAO iAppeals Non-Medical: Internet Version 1.1 9.5. Attach Files 3rd Party 9.6. Attach Files 3rd Party – If either “Yes, paper documents” OR “No, no documents to submit” is selected, File Details panel is not shown. User is taken to Summary. DCS/OITBS/OITEBS/DUEAA /UXG 32 Screen Package Document – OAO iAppeals Non-Medical: Internet Version 1.1 9.7. Attach Files 3rd Party – If either “Yes, documents in electronic format” OR “Yes, both electronic and paper documents” is selected, show File Details panel. DCS/OITBS/OITEBS/DUEAA /UXG 33 Screen Package Document – OAO iAppeals Non-Medical: Internet Version 1.1 9.8. Attach Files 3rd Party – File Added DCS/OITBS/OITEBS/DUEAA /UXG 34 Screen Package Document – OAO iAppeals Non-Medical: Internet Version 1.1 10. Summary 10.1. Summary 1st Party DCS/OITBS/OITEBS/DUEAA /UXG 35 Screen Package Document – OAO iAppeals Non-Medical: Internet Version 1.1 10.2. Summary 3rd Party DCS/OITBS/OITEBS/DUEAA /UXG 36 Screen Package Document – OAO iAppeals Non-Medical: Internet Version 1.1 11. Confirmation 11.1. Confirmation 1st Party DCS/OITBS/OITEBS/DUEAA /UXG 37 Screen Package Document – OAO iAppeals Non-Medical: Internet Version 1.1 11.2. Confirmation 3rd Party – Preparer DCS/OITBS/OITEBS/DUEAA /UXG 38 Screen Package Document – OAO iAppeals Non-Medical: Internet Version 1.1 11.3. Confirmation 3rd Party – Appointed Representative DCS/OITBS/OITEBS/DUEAA /UXG 39 Screen Package Document – OAO iAppeals Non-Medical: Internet Version 1.1 12. Receipt 12.1. Receipt 1st Party DCS/OITBS/OITEBS/DUEAA /UXG 40 Screen Package Document – OAO iAppeals Non-Medical: Internet Version 1.1 12.2. Receipt 3rd Party DCS/OITBS/OITEBS/DUEAA /UXG 41 Screen Package Document – OAO iAppeals Non-Medical: Internet Version 1.1 13. Cover Sheet 13.1. Cover Sheet 1st Party DCS/OITBS/OITEBS/DUEAA /UXG 42 Screen Package Document – OAO iAppeals Non-Medical: Internet Version 1.1 13.2. Cover Sheet Popup 3rd Party DCS/OITBS/OITEBS/DUEAA /UXG 43 Screen Package Document – OAO iAppeals Non-Medical: Internet Version 1.1 14. Message Pages 14.1. Message 010 - Authorization Failure 14.2. Message 024 - Cookies Disabled DCS/OITBS/OITEBS/DUEAA /UXG 44 Screen Package Document – OAO iAppeals Non-Medical: Internet Version 1.1 14.3. Message 025 - Session Timeout 14.3.1. Message 026 - We cannot process your request DCS/OITBS/OITEBS/DUEAA /UXG 45 Screen Package Document – OAO iAppeals Non-Medical: Internet Version 1.1 14.4. Message 027 - We are processing your request 14.5. Message 028 - This service is not available at this time DCS/OITBS/OITEBS/DUEAA /UXG 46 Screen Package Document – OAO iAppeals Non-Medical: Internet Version 1.1 14.6. Message 030 - We are processing your request 14.7. Message 045 - Service Hours DCS/OITBS/OITEBS/DUEAA /UXG 47 Screen Package Document – OAO iAppeals Non-Medical: Internet Version 1.1 14.8. Message 052 - SSN Blocked 14.9. Message 113 - Number of Attempts Limit DCS/OITBS/OITEBS/DUEAA /UXG 48 Screen Package Document – OAO iAppeals Non-Medical: Internet Version 1.1 14.10. Message 151 – Unable to Verify ZIP DCS/OITBS/OITEBS/DUEAA /UXG 49