Persons
claiming retirement, disability or survivor
as well as unemployment or sickness benefits
from the Railroad Retirement Board 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 Railroad Retirement Board.
Persons dissatisfied with the initial decision
on their claims may first request reconsideration
from the Board unit which denied their claims.
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 or unemployment-sickness claim, a person
may appeal to the Railroad Retirement Board'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 or conducted by telephone.
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 Board 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 Railroad Retirement Board.
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 Railroad Retirement Board?
Appellants not satisfied with the Board's final
decision may then file a petition with the 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 or survivor as
well as 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 Board's
Bureau of Hearings and Appeals, 844 North Rush
Street, Chicago, Illinois 60611-2092 or from
the Board's Web site at www.rrb.gov. The appropriate
forms can also be obtained from any Railroad
Retirement
Board field office, as can assistance in
filing a request for review at each of the administrative
levels. Persons can find the address and phone
number of the Board office serving their area
by calling the automated toll-free
RRB Help-Line at 1-800-808-0772 or by checking
the Board's Web site. Most field offices are
open to the public from 9:00 a.m. to 3:30 p.m.,
Monday through Friday, except on Federal holidays.
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