Railroad Retirement Board
Appeals Procedures
May 2007
Persons claiming retirement, disability, survivor,
unemployment or sickness benefits from the Railroad Retirement Board (RRB) have
the right to appeal unfavorable determinations on their claims. The following
questions and answers describe the appeals process for persons whose claims
under the Railroad Retirement Act or Railroad Unemployment Insurance Act are
denied, or who are dissatisfied with decisions on their claims.
1.
How does a person initiate a review of an unfavorable decision on a claim and
what are the time limits?
For all claims under the Railroad Retirement and Railroad Unemployment
Insurance Acts there is a three-stage review and appeals process within the
RRB. An individual dissatisfied with the
initial decision on his or her claim may first request reconsideration from the
RRB unit which denied the claim. This step is mandatory before a decision may
be appealed to the RRB's Bureau of Hearings and Appeals. An individual has 60
days from the date of the initial denial notice to file a written statement
requesting reconsideration.
In cases involving overpayments, requests for waiver of recovery of the
overpayment must be filed within 60 days of the date of the overpayment notice.
In such cases, recovery of the overpayment will be deferred and a personal
conference may be held, if requested. A request for waiver received after 60
days will be considered but will not defer collection of the overpayment, and
any amount of the overpayment recovered prior to the date on which the waiver
request is filed will not be subject to waiver.
2.
What are the second and third stages of the appeals process and their time
limits?
If dissatisfied with the reconsideration or waiver decision on a retirement,
disability, survivor, unemployment or sickness claim, a person may appeal to
the RRB's Bureau of Hearings and Appeals, which is independent of those units
responsible for reconsideration decisions. An appellant has 60 days from the
date of the reconsideration or waiver decision notice to file this appeal. An oral
hearing may be held under certain circumstances. This hearing may be in person,
conducted by telephone or, in some cases, by video conferencing.
If not satisfied with the Bureau of Hearings and Appeals' decision, an
appellant may further appeal to the three-member Board. Sixty days from the
date of the notice of the Bureau of Hearings and Appeals' decision are allowed
for filing this appeal. The three-member Board will base its decision on the
evidence before the hearings officer. The three-member Board ordinarily will
not accept additional evidence or conduct a hearing.
3.
What are the criteria applied to requests for waivers of retirement,
disability, or survivor benefit overpayments, and unemployment or sickness
benefit overpayments?
A person's obligation to repay any erroneous benefit payments may be waived
only if the following conditions are met:
(1) The person was not at fault in causing the overpayment; and (2)
recovery of the overpayment would cause financial hardship to the extent that
he or she would not be able to meet ordinary and necessary living expenses, or
recovery would be against equity or good conscience. "Against equity or
good conscience" is defined in the regulations of the RRB as meaning that
the claimant has, by reliance on the payments made to him or her, or on notice
that payment would be made, relinquished a significant and valuable right or
changed his or her position to his or her substantial detriment. In cases involving unemployment or sickness
benefits, there is an additional requirement that the overpayment must be more
than 10 times the current maximum daily benefit rate. Persons requesting waiver may be asked to
complete a financial statement on a form provided by the RRB.
4.
What happens if a person's appeal is not filed within the prescribed time
limit?
Failure to request reconsideration or to file an appeal within the allocated
time period will result in forfeiture of further appeal rights, unless there is
good cause for the delay. Some examples of good cause include: serious illness;
a death or serious illness in the appellant's immediate family; destruction of
important or relevant records; failure to be notified of a decision; an unusual
or unavoidable circumstance which demonstrated that the appellant could not
have known of the need for timely filing or which prevented the appellant from
filing in a timely manner; or the claimant thought that his or her
representative had requested reconsideration or appeal. If good cause is not
established, further appeal is forfeited, except that the appellant may contest
the determination that the request for reconsideration or the appeal was not
filed timely.
5.
Are there avenues of appeal beyond the RRB?
Appellants dissatisfied with the three-member Board's final decision may then file
a petition with a U.S. Court of Appeals to review the Board's decision. In
cases involving retirement, disability or survivor claims, the petition for
review must be filed within one year of the date of the three-member Board's
decision notice. In cases involving claims for unemployment or sickness
benefits, the petition for review must be filed within 90 days of the Board's
decision notice.
6.
Can employers contest the claims of their employees for unemployment and
sickness benefits?
When an employer is a party to the claim for benefits, that employer may
protest the payment of benefits, but such protests do not prevent the timely
payment of benefits. However, an employee may be required to repay benefits if
his or her employer's protest is ultimately successful.
7.
Where can a person obtain retirement, disability, survivor, unemployment or
sickness benefit appeals forms and assistance in completing the forms?
Requests for reconsideration of an initial decision must be in writing, but do
not have to be on any specific form. The appropriate form for waiver of
recovery of a benefit overpayment is ordinarily enclosed with the overpayment
notice. The forms to appeal to the Bureau of Hearings and Appeals and the
three-member Board are available from the RRB's Bureau of Hearings and Appeals,
Public Affairs 312-751-4777
Posted: 05/15/07