Railroad Retirement Board
RRB Appeals Procedures
November 2008
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.
RRB Form HA-1, which is used to appeal to the Bureau of Hearings and
Appeals and the three-member Board, is available from the RRB’s
Bureau of Hearings and Appeals,
.
Public Affairs 312-751-4777
Posted: 05/15/07