Other Fields
Agency Scheme: 
HHSOADGA0008
Level: 
Appeal Level One
ADJUDICATION STRUCTURE
Appeals: Basic Structure
Appeal Office (local name): 
Departmental Appeals Board
Appeal Office (global name): 
Department of Health and Human Services: Departmental Appeals Board
Sub-Agency/Bureau/Division:: 
Appellate Division
Appeal Officer #1 (Title): 
Board Member
Are administrative appeals permitted from final decisions issued by this appellate office?: 
No
Comments/Notes on Adjudication Structure: 
The name “Departmental Appeals Board” is used to refer to two entities: (1) the decision-making body consisting of Board Members, appointed by the Secretary, who issue decisions made by panels of three Board Members; and (2) the larger organization, located within the Office of the Secretary, which includes the Board, Administrative Law Judges (ALJs), Administrative Appeals Judges who serve on the Medicare Appeals Council, and organizational divisions that support the judges and other administrative functions. The term “Board” is used to refer to the decision-making body and the acronym “DAB” to refer to the larger organization. The Appellate Division of the DAB provides staff support for the Board Members, who are career civil servants appointed by the Secretary to provide an impartial, independent review of disputes arising in a wide range of HHS programs. The Board's jurisdiction arises from the Board's "charter" at 45 C.F.R. Part 16, program statutes, regulations, and delegations by the Secretary or heads of HHS operating components. The Board provides de novo review (which may include an evidentiary hearing) of certain types of final decisions of HHS operating components, such as determinations in discretionary, project grant programs and determinations in mandatory grant programs. The Board also provides appellate review of certain types of ALJ decisions, which may be appealed by either party. These include most types of decisions of ALJs assigned to the DAB, decisions of Food and Drug Administration ALJs regarding civil money penalties, and decisions of Department of the Interior ALJs in Indian Health Service contract/compact cases. In most cases, the Board decision is the final administrative decision of HHS.
PROCESS & PROCEDURE - General Information
Which party (or parties) is/are permitted to file appeals with this office?: 
Either
Are private parties permitted to have representation at appeal hearings?: 
Yes (All Types of Cases)
Who may serve as a private party representative?: 
Either
Is the agency permitted to have representation at appeal hearings?: 
Yes (All Types of Cases)
Who may serve as an agency representative?: 
Attorney
Are ex parte contacts prohibited?: 
No
Regulations/rules of practice for appeal hearings (please include CFR citations): 
45 CFR Part 16
Other published guidance for appeal hearings (if any): 
Guidelines are posted on the DAB's website at, http://www.hhs.gov/dab/divisions/appellate/guidelines/index.html.
PROCESS & PROCEDURE - Hearing Procedure
What types of hearings are permitted on appeals adjudicated by this office?: 
Written (Document-Only) Hearing
In-Person
Video
Phone
Please provide the approximate percentage of each type of hearing relative to the total number of appeal hearings (FY2013)
Written (Document-Only) Hearing: 
91%
In-Person: 
1%
Phone: 
8%
How is the type of hearing selected for appeals heard by this office?: 
By Agency
By Private Party
Required by Rule
Depends on Nature of Case/Claim
If "Depends on Nature of Case/Claim", please describe: 
The Presiding Board Member will decide whether a hearing is required. An evidentiary hearing is appropriate where there are material facts in dispute and the record requires further factual development through testimony. In addition, a hearing may be appropriate where the nature of the issues or complexity of the case otherwise warrants development in an adversarial hearing format. Similarly, an oral argument may be appropriate where there are no material issues of fact in dispute (or the record on material disputed facts is already substantially contained in the appeal file), but legal issues remain that require clarification or argument beyond the briefs.
How many appeal officers preside at each hearing?: 
One
If "Varies by Case," please describe: 
The presiding Board Member will conduct the proceeding; other Board Members on the panel may attend as their schedules permit.
Is factual development permitted at the appellate hearing as a means of supplementing the record from below?: 
Yes (Some Types of Cases)
Can third-parties submit amicus briefs and/or evidence?: 
Yes
Adjudication Officer Discretion
Are appeal hearings recorded and/or transcribed?: 
Yes
Are appeal hearings open to the public?: 
Presumed Open (But May Be Closed Under Certain Conditions)
PROCESS & PROCEDURE - Post-Hearing Procedure
Who typically drafts final decisions on appellate cases adjudicated by this office?: 
Adjudication Officer
Staff Attorney
Who has authority to issue final decisions on appellate cases adjudicated by this office?: 
Adjudication Officer
Do agency regulations or guidance provide time limits for issuance of final decisions on appellate cases?: 
Yes (Some Types of Cases)
If "Yes," please specify these time limit(s): 
The regulations applicable to some types of case may provide time limits for issuance of final decisions. For example, in denial of enrollment application cases, the Board must issue a decision, dismissal order or remand to the ALJ no later than 180 days after the appeal is received by the Board. 42 CFR 498.88(g). The regulations governing the type of case should be consulted to determine whether time limits apply.
About how long does it take on average—as of FY2013—to adjudicate appeals by this office?: 
180 Days
Is judicial review available after issuance of a final decision on appellate cases adjudicated by this office?: 
Yes (All Types of Cases)
PROCESS & PROCEDURE - Case Management
How are claims/cases processed at this appellate office?: 
Other
Please briefly describe your case management practice(s) at this office: 
Generally, cases are processed in order received. However, cases in which regulatory deadlines apply will generally take precedence over cases without regulatory deadlines.
Does the agency permit web-based electronic filing of briefs or other documents in cases adjudicated by this appellate office?: 
Yes
Are final decisions issued by this appellate office published and/or posted on the agency website?: 
Yes (All Decisions)
Do agency regulations/rules of practice specify the contents of the administrative record on appeals heard by this office?: 
Yes (Some Types of Cases)
If "Yes," please provide citation(s): 
The regulations governing the type of case should be consulted to determine the contents of the administrative record.
Do agency regulations/rules of practice provide for closure of the record on appeals heard by this office?: 
No
If "Yes," please provide citation(s): 
The regulations governing the type of case should be consulted to determine when the record closes.
PROCESS & PROCEDURE
Comments/Notes on Appellate Process & Procedures (Optional): 
Regarding party representation: The regulations governing the type of case may specify whether a party's representative must be an attorney. 45 CFR Part 16 sets the procedure for Board review; however, some Federal components have issued guidelines modifying the Part 16 procedures. A list of those regulations can be found at http://www.hhs.gov/dab/divisions/appellate/regulations/regulations.html.
ADJUDICATORS
Total # of Appeal Officers: 
5
ADR: General Information
Is ADR available at one or more points for appellate cases heard by this office?: 
Yes
If "Yes," when is ADR available?: 
Pre-Hearing
Post-Hearing
Is ADR a mandatory or voluntary process?: 
Voluntary
What type(s) of ADR are available?: 
Mediation
If "Other," please specify:: 
http://www.hhs.gov/dab/divisions/adr/index.html
Who conducts the ADR?: 
Third-Party Neutral
Regulations/rules of practice governing ADR process (please include CFR citations): 
http://www.hhs.gov/dab/divisions/adr/standards/standards.html
Other published guidance on ADR process (if any):: 
http://www.hhs.gov/dab/divisions/adr/mediation/process.html
ADR – Summary Statistics
Comments/Notes on ADR Statistics (Optional): 
The case types listed above include only those cases over which the Board has original jurisdiction.
CASELOAD STATISTICS - Summary Statistics
Total # Cases Filed/Opened (FY2013): 
117
Total # Cases Decided/Closed (FY2013): 
109
Total # Cases Pending (End of FY2013): 
51
CASELOAD STATISTICS - Supplementary Statistics
Does your agency maintain annual caseload statistics for this hearing office by case type (e.g., discrimination complaint, licen: 
Yes
If "Yes," please indicate preferred format below.: 
By providing case type statistics on this form
WRAP-UP
Do you have any additional comments about your agency's responses on this form? If so, please provide comments below.: 
The Board has jurisdiction over a wide range of cases with many different governing regulations. Therefore, it is not practical to list all the applicable regulations as requested in this form. Please feel free to follow up with the contact listed below if you require additional information.
Are there distinctive or innovative features of the appellate-level adjudication program covered on this form that you wish to: 
The DAB implemented an electronic filing (DAB E-File) system in 2012. The use of DAB E-File has increased productivity and saved costs for not only the DAB, but also for the parties that appear before it. In addition, the DAB conducts hearing using video teleconferencing (VTC). VTC permits for more flexibility and saves both the government and parties travel related costs. Both these measures also contributed to a large reduction of the DAB's carbon footprint.
Verified by Agency: 
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