If the claimant inquires about the favorable decision and the case is electronic, go to eView or the Case Processing Management System (CPMS) to check on the status of the case. If the case is paper, and the claim folder(s) has not yet been received, obtain an Office of Hearings Operations (OHO) query to determine the folder location and the status of the hearing decision.

Contact the regional office about locating or reconstructing the file if the OHO query shows that a favorable decision was issued and the claim folder(s) has been in transit for more than 10 days,

Take the following steps before payment effectuation:

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  Review the file to determine what additional evidence or development is needed, especially in the area of capability.

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  If the claimant is determined incapable, see GN 00504.105 regarding payment of current benefits while withholding retroactive benefits.

Take the following steps to conduct a PERC:

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  Initiate a PERC with the claimant.

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  Refer to SI 00603.003 for processing deferred development claims.

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  Refer to SI 00603.004 for processing simultaneous development claims.

Do not delay payment pending a determination of capability.

Effectuate payment after receiving the ALJ decision and all development is complete as follows:

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  Locate the diagnosis code(s) and the regulation basis code for the decision on the OHO CPMS.

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  Determine the appropriate medical diary. A remark is generated on the CPMS transmittal sheet only for those cases where medical improvement is expected (MIE) or medical improvement is not expected (MINE) is applicable. The diaries that are coded would be less than 3 years for MIE cases and a 7-year diary for MINE cases. If no remark is shown, assume that a 3-year medical improvement possible (MIP) diary is applicable. If the FO has any questions relating to the information on the CPMS transmittal sheet, contact the hearing office manager annotated in the claim folder(s).

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  To input the diagnosis code(s) and medical diary, follow the processing instructions in SI 00603.040D.

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  Input the coding to the Supplemental Security Record (SSR) when the claim is effectuated. See SM 01305.900.

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  View the Query Modify Medical Data (QMMD) screen of the Disability Control File (DCF) to ensure that the diagnosis and diary information has propagated from the SSR. The SSR should update the DCF within 72 hours of your input. If the diagnosis and diary information do not appear on the MMDS, follow the instructions in DI 13010.640 to input the information manually.

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  Follow current procedures for release of the notice.