I-1-8-4.Complaints

Last Update: 4/12/13 (Transmittal I-1-64)

A. Complaints Filed by the Public, Government Entities, Social Security Administration Personnel

1. Who May File a Complaint

The following public individuals may file a complaint with the Division of Quality Service (DQS):

  • the claimant,

  • another party to the hearing,

  • someone authorized to act on the claimant's or other party's behalf including but not limited to the claimant's representative, or

  • an individual who was present at the claimant's hearing.

Social Security Administration (SSA) personnel, including those in SSA's Office of the Inspector General, and government entities, such as Members of Congress, and the Federal courts also may file a complaint with DQS. Individuals and entities who may file a complaint and do file a complaint are referred to as “complainants.”

If DQS receives a complaint from an individual or entity who is not a complainant as identified above, DQS will notify that individual or entity that it will not review the complaint.

2. What the Complaint Should Contain

DQS will consider a written complaint that sufficiently details the relevant facts. A complaint should include:

  • specific allegations about the type of ALJ conduct that DQS has the authority to investigate,

  • descriptions of when and where the alleged misconduct occurred,

  • witnesses to the alleged misconduct, if any, and

  • the complainant's name, address and telephone number.

If the complaint does not sufficiently detail the relevant facts, DQS will send a letter informing the complainant about the insufficiency. The letter will inform the complainant that he or she has 30 calendar days to supply the necessary information.

  • If DQS receives the necessary information within 30 calendar days, the complaint will be acknowledged and reviewed using the procedures described in HALLEX I-1-8-7. If DQS does not receive the letter containing the necessary information from the complainant within 30 calendar days, but the postmark on the letter is within 30 calendar days, DQS will accept the complaint for processing.

  • If DQS does not receive the necessary information within 30 calendar days or the response is not postmarked within 30 days of the requested date, DQS will close out the matter without any review or notification to the complainant.

NOTE:

To account for mailing time, DQS assumes the complainant received the letter 5 days after the date shown on this notice unless the complainant shows he or she did not receive it within the 5-day period.

3. When to File the Complaint

The complaint must be filed with DQS or postmarked within 180 calendar days of the date of the alleged conduct, or the date the complainant became aware of such conduct. If using the latter, the complainant should indicate when he or she became aware of the conduct and the circumstances surrounding the discovery of that conduct.

If the complaint is untimely, DQS will notify the complainant that the complaint is untimely and that it will not process the complaint.

4. Where to File the Complaint

While a complaint may be filed with any SSA office, complainants should be filed directly with DQS to avoid delays in processing. The complainant should send the complaint and any supporting documentation to DQS at:

Office of Disability and Adjudication Review

Attn: Division of Quality Service, Suite 1702

5107 Leesburg Pike

Falls Church, VA 22041-3255

In the unusual circumstance that a complaint cannot be directly filed with DQS, a complainant may file it with the SSA Teleservice Center (by calling 1-800-772-1213), or any other SSA office. SSA employees receiving a complaint should fill out a Report of Contact (SSA-5002) summarizing the complaint and forward it to DQS for acknowledgement and review. This will serve as the writing requirement under HALLEX I-1-8-4 A.2. However, if the complaint is filed with an Office of Disability Adjudication and Review Regional Office or the National Hearing Center Central Office, those offices will acknowledge the complaint under the instructions in HALLEX I-1-8-7, and then forward it to DQS for review.

B. Appeals Council (AC) Referrals

Pursuant to (SSR) 13-1p: Titles II and XVI: Agency Processes for Addressing Allegations of Unfairness, Prejudice, Partiality Bias, Misconduct, or Discrimination by Administrative Law Judges (ALJs), the Appeals Council (AC) will refer certain allegations of ALJ misconduct to DQS. The AC will follow the procedures for referral to DQS set forth in HALLEX I-3-1-25. DQS will accept referrals from the AC regarding:

  • An ALJ's egregious conduct identified by an Administrative Appeals Judge (AAJ), as explained in HALLEX I-3-1-25 C., even if the file contains no written allegation.

  • Allegations that fall outside of the AC's adjudicative authority, such as an allegation that the ALJ violated personnel regulations or policies.

  • Allegations that an ALJ shows general bias or a pattern of bias or misconduct against a group or particular category of claimants. For example, in association with a request for review, the claimant may allege, “the ALJ is biased against claimants who receive workers compensation benefits or unemployment benefits,” or “The ALJ shows prejudice toward women.”