withdrawal of an application, a reconsideration of an initial determination, a hearing, a review of a hearing examiner's decision, or for appointment of a representative:

OA-C521-Request for Withdrawal of Ap

plication. (For use by an individual to cancel his application.) OA-C561-Request for Reconsideration. (For use by an individual who disagrees with an initial determination concerning (a) entitlement to benefits or any other right under title II of the Social Security Act, or (b) entitlement to hospital insurance benefits or supplementary medical insurance benefits under title XVIII of the Act, or (c) the amount of hospital insurance benefits under such title XVIII to obtain a review of his case. See § 422.140 for a discussion of the reconsideration procedure.) HA-501-Request for Hearing. (For use by an individual or institution to obtain a hearing before a hearing examiner of the Social Security Administration. See § 422.203 for a discussion of the hearing procedure.) HA-512-Appointment of Representative.

(For use by person other than an attorney authorized by a claimant to act for him in a claim or related matter.) HA-512.1-Notice by Attorney of Appointment as Representative. (For use by an attorney authorized by a claimant to act for him in a claim or related matter.) HA-520-Request for Review of Hearing Ex

aminer's Action. (For use by an individual or institution to obtain a review of a decision by a hearing examiner of the Social Security Administration.)

The following forms are used by the Social Security Administration and by the public in connection with the maintenance of earnings records of wage earners and self-employed persons: SS-4-Application for Employer Identification Number.

SS-4A-Agricultural Employer's Application.

(For use by employers of agricultural workers to request an employer identification number under the FICA.) SS-5-Application for Social Security Number (or Replacement of Lost Card). SS-15-Certificate Waiving Exemption From Taxes Under the FICA. (For use by certain nonprofit organizations requesting coverage of its employees.) SS-15a-List of Concurring Employees. (To

be signed by each employee who concurs in the filing of the Certificate Waiving Exemption From Taxes Under the FICA, Form SS-15.)

OASI-21-Social Security and Your Household Employee. (For use by employers of household workers to request information from the District Director of Internal Revenue regarding filing employee tax reports.)

OA-702-Account Number Card. OA-702.1-Duplicate Account Number Card. Form 2031-Waiver Certificate To Elect Social Security Coverage for Use by Ministers, Certain Members of Religious Orders, and Christian Science Practitioners.

Form 4029-Application for Exemption From Tax on Self-Employment Income, Claim for Refund, and Waiver of Benefits. (To be completed by self-employed individuals who are members of certain recognized religious sects (or division thereof) and do not wish to pay FICA taxes or participate in the programs provided under titles II and XVIII.) Form 4361-Application for Exemption From Self-Employment Tax for Use By Ministers, Members of Religious Orders, and Christian Science Practitioners. Form 4415-Election To Exempt From SelfEmployment Coverage Fees Received by Certain Public Officers and Employees of a State or a Political Subdivision Thereof.

OAAN-5028-Temporary

Account Number

Card. OAAN-7003-Request for Change in Social Security Records. (For use by an individual to change information given on original application for an account number.) OAR-7004-Request for Statement of Earnings. (For use by worker to obtain a statement of earnings recorded in his earnings record.)

OAR-7008-Request for Correction of Earnings Record. (For use by an individual who wishes to have his earnings record revised.) SSA-7011-Statement of Employer. (For use by an employer to provide evidence of wage payments in cases of a wage discrepancy in an individual's earnings record.)

[32 F.R. 18030, Dec. 16, 1967, as amended at 33 F.R. 11280, Aug. 8, 1968]

§ 422.525 Where applications and other forms are available.

All applications and related forms prescribed for use in the programs administered by the Social Security Administration pursuant to the provisions of titles II and XVIII of the Act are printed under the specifications of the Administration and distributed free of charge to the public, institutions, or organizations for the purposes described therein. All prescribed forms can be obtained upon

request from any social security district office or branch office (see § 422.5). Forms appropriate for use in requesting payment for services provided under the health insurance for the aged programs can also be obtained from the intermediaries or carriers (organizations under contract with the Social Security Administration to make payment for such services) without charge. Form 2031 (Waiver Certificate To Elect Social Security Coverage for Use by Ministers, Certain Members of Religious Orders, and Christian Science Practitioners), Form 4029 (Application for Exemption From Tax on Self-Employment Income, Claim for Refund, and Waiver of Benefits), Form 4361 (Application for Exemption From Self-Employment Tax for Use by Ministers, Members of Religious Orders, and Christian Science Practitioners), Form 4415 (Election To Exempt From Self-Employment Coverage Fees Received by Certain Public Officers and Employees of a State or a Political Subdivision Thereof), Form SS-4 (Application for Employer Identification Number), Form SS-4A (Agricultural Employer's Application for Identification Number), Form SS-5 (Application for Social Security Number (or Replacement of Lost Card)), Form SS-15 (Certificate Waiving Exemption From Taxes Under the FICA), and Form SS-15a (List of

Concurring Employees) can also be obtained without charge from offices of the Internal Revenue Service. For other offices where applications and certain other forms can be obtained, see Subparts B and C of this Part 422.

[33 F.R. 11280, Aug. 8, 1968]

§ 422.527 Private printing and modification of prescribed applications and other forms.

Any person, institution, or organization wishing to reproduce, duplicate, or privately print any application or other form prescribed by the Administration should obtain the prior approval of the Administration. Requests for approval to so reproduce any prescribed form must be in writing and include the reason or need for such reproduction, the intended user of the form, the proposed modifications, if any, the proposed format, with printing or other specifications, the type of automatic data processing machinery (e.g., printer, burster, mail handling), if any, for which the form is being designed, estimated printing quantity, estimated cost per thousand, estimated annual usage, and such other pertinent information as may be required by the Administration. All requests are to be forwarded to: Social Security Administration, Printing and Records Management Branch, Baltimore, Md. 21235.

[33 F.R. 11281, Aug. 8, 1968]

(a) "Act" means the Federal Employees' Compensation Act and any statutory extension or application thereof.

(b) "Board" means the Employees' Compensation Appeals Board.

(c) "Bureau" means the Bureau of Employees' Compensation and in the case of employees of the Canal Zone Government and of the Panama Canal Company, the Governor of the Canal Zone.

(d) "Director" means the Director of the Bureau and in the case of employees of the Canal Zone Government and of the Panama Canal Company, the Governor of the Canal Zone.

(e) "Party" means any person admitted and named as a party on the docket of the Board, including any intervenors.

(f) "Counsel" includes any person who is a member in good standing of the bar of the Supreme Court of the United States or the highest court of any State, territory, or the District of Columbia. [27 F.R. 12186, Dec. 8, 1962, as amended at 29 FR. 13519, Oct. 1, 1964]

§ 501.2 Scope and applicability of rules; composition and jurisdiction of the Board.

(a) The regulations in this part provide the rules of practice of the Board in hearing and deciding appeals from final decisions of the Bureau.

(b) The Board consists of three members appointed by the Secretary of Labor, one of whom is designated as Chairman of the Board and administrative officer.

(c) The Board has jurisdiction to consider and decide appeals from the final decision of the Bureau in any case arising under the Act. The Board may review all relevant questions of law, fact, and discretion in such cases. There shall be no appeal with respect to any interlocutory matter disposed of by the Bureau during the pendency of a case. The review of a case shall be limited to the evidence in the case record which was before the Bureau at the time of its final decision.

§ 501.3 Application for review.

(a) Who may file. Any person adversely affected by a final decision of the Director, or his duly authorized representative, may file an application for review of such decision by the Board.

(b) Place of filing. Any application for review shall be filed with the Clerk of the Board, Employees' Compensation

Appeals Board, U.S. Department of Labor, Washington 25, D.C.

(c) Form of application; contents. An application for review should be filed with the Board upon Form AB-1 (Application for Review). Any application made without the use of the form shall contain the following information: The full name and address of the applicant, the name of the injured or deceased employee, the employing establishment, the case file number assigned to the case by the Bureau, a description of the particular injury involved, the date of the injury, the place of injury, and the date of the decision being appealed. If the applicant is being represented by another person in the proceeding, the name and address of such representative should be stated. Each application shall include a succinct statement indicating the contentions of the applicant and describing with particularity any findings of fact, conclusions of law, or exercise of (or failure to exercise) discretion complained of. Any application containing incomplete information shall be returned to the applicant with a description of the additional information needed and a reasonable opportunity for furnishing any such information shall be allowed.

(d) Time for filing. (1) Except as provided in subparagraph (2) of this paragraph, any application for review by a person residing within the United States or Canada must be filled within 90 days from the date of issuance of the final decision of the Director, and any application for review by a person residing outside the United States or Canada must be filled within 180 days from the date of issuance.

(2) For good cause shown, the Board may in its discretion waive a failure to file an application within the time limitations provided in subparagraph (1) of this paragraph, but for no longer than one year from the date of issuance of the final decision of the Director.

(3) The date of filing of an application for review shall be the date upon which the application is received by the Board.

(e) Briefs and supporting statements. Any application for review may be accompanied by a brief or supporting statement.

§ 501.4 Transmittal of record.

The Board shall serve upon the Director a copy of each application for re

view and any brief or supporting statement accompanying it. Within 30 days from the date of such service, the Director shall transmit to the Board the record of the proceeding to which the application refers and such statement in support of his decision or other pleading as he may consider necessary, but on application of the Director, the Board may in its discretion extend such time. § 501.5 Oral argument.

(a) Notice. Whenever any party requests an opportunity to present oral argument the Board shall schedule the case for argument. Each party shall be notified at least 10 days before the date of argument. The notice shall state the issues to be heard, as determined by the Board.

(b) Time allowed. Generally not more than 1 hour shall be allowed for oral argument by any party although in appropriate cases the Board may in its discretion extend or shorten the time allowed.

(c) Failure to respond to notice. Failure to respond to a notice of oral argument shall not prejudice the rights of any party to the proceeding. The Board in its discretion may set the case for further argument upon notice or it may proceed to dispose of the appeal pursuant to § 501.6.

(a) The decision of the Board shall contain a written opinion setting forth the reasons for the action taken and an appropriate order. The decision may consist of affirmance, reversal, remand for further development of the evidence, or other appropriate action. A copy of the decision shall be sent by the Board to all parties in interest. The case record shall be returned to the Director with a copy of the decision.

(b) A decision of not less than two members shall be the decision of the Board.

(c) The decision of the Board shall be final as to the subject matter appealed and such decision shall not be subject to review, except by the Board.

(d) The decision of the Board shall be final upon the expiration of 30 days from the date of the filing of the order, unless the Board shall in its order fix a different period of time or reconsideration by the Board is granted.

A petition

(a) Procedure for filing. for reconsideration of a decision of the Board may be filed with the Board within 30 days from the date of the order, or, if another period is specified in the order, then prior to the time when the order becomes final. The petition shall state the grounds relied upon, including any matters claimed to have been erroneously decided and shall specify the alleged errors. The petition may be in letter form.

(b) Answer; procedure for disposition of petitions. Upon the filing of a petition for reconsideration, each of the other parties to the proceeding may file an answer thereto within such time as may be fixed by the Board. If reconsideration should be granted, reargument upon reasonable notice may be allowed in the discretion of the Board. After reconsideration of a case the Board shall either grant or deny the petition. § 501.8 Docket of proceedings; inspection of docket and records.

(a) Maintenance of docket. A docket of all proceedings shall be maintained by the Board. Each proceeding shall be assigned a number in chronological order upon the date on which an application for review is received. Each proceeding shall be generally considered in the order in which it is docketed, although for good cause shown the Board may advance the order in which a particular case is to be considered. Correspondence or further applications in connection with any pending case shall refer to the docket number of that case.

(b) Inspection of docket and records. The docket of the Board shall be open to public inspection. The Board shall publish its decisions in such form as to be readily available for inspection, and shall allow the public inspection thereof at the permanent location of the Board. The papers and documents included in the record of any proceeding shall be made available to any party in interest as provided in 29 CFR 2.6(b). The Board shall exercise the functions of the Secretary of Labor prescribed in 29 CFR 2.6(b). Such inspection shall be permitted at reasonable times during business hours upon written request therefor filed with the Board by an interested party. Any request must set forth (1) the interest of the applicant in the proceeding, and (2) a description of the

specific materials desired to be inspected. Any request will be denied as to any papers or documents which the Board determines are confidential, including, but without limitation, papers and documents containing information affecting the security of the United States or adversely affecting the interests of the United States or medical or other information which might result in damage or harm to the appellant or any other person.

§ 501.9 Regulation of proceedings.

The proceedings shall be conducted under the supervision of the Chairman or Acting Chairman, who shall regulate such matters as the granting of continuances, acceptance of briefs and other procedural matters.

§ 501.10 Number of copies of pleadings and related documents; service.

(a) Except as provided in paragraph (b) of this section, any application, pleading, petition, brief or other memorandum shall be filed in duplicate (original and 1 copy) with the Board; the Board shall serve the copy upon the other party.

(b) Instead of filing the duplicate of any such document with the Board, the party submitting it may serve the duplicate or copy directly upon the Director and make a notation to that effect upon the copy filed with the Board.

(c) Any notice or order required under this part to be given or served shall be by certified or registered mail or by personal service.

§ 501.11 Appearances.

(a) Representation. In any proceeding before the Board, a party may appear in person, or by counsel or any other duly authorized person, including any accredited representative of an employee organization. No person shall be recognized as representing an appellant or intervenor unless there shall be filed with the Board a statement in writing, signed by the party to be represented, authorizing such representation. Such representative when accepted shall continue to be recognized unless he should abandon such capacity, withdraw, or the appellant or intervenor directs otherwise.

(b) Former members of the Board; other employees of the Department of Labor. A former member of the Bcard shall not be allowed to participate as