When the claimant does not comply within 10 calendar days from the date of your initial
request for evidence (e.g., submitting a completed form) or action (e.g., calling
a doctor to request they fax a medical record), follow up once by telephone or letter.
Give the claimant 10 additional calendar days from the date of your follow-up to comply
with your initial request, unless the claimant provides a good reason for you to give
more time.
To determine the required contact(s) for follow up when a claimant fails to cooperate
with an initial request or a scheduled CE, see DI 23007.005.
For the definition of good reason, see DI 23007.001B.
For claims requiring special handling, see DI 23007.001A.
NOTE 1: When the claimant requires special handling and the claimant does not comply with
your initial request for evidence or action in the additional time that you have given,
you must also make a reasonable effort to identify and involve a third party, see
DI 23007.010.
NOTE
2: When you stopped your attempts to get the claimant to attend a consultative examination
(CE) appointment in accordance with DI 22510.019, do not further attempt to obtain the claimant’s cooperation in providing additional
evidence or taking additional action. Make a reasonable attempt to obtain evidence
available without the claimant's cooperation and make a determination using the sequential
evaluation process, see DI 23007.015.
1. Follow up by telephone
a. You speak to one of the required contacts
When you speak to the contact, do the following during the conversation:
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Verify the claimant's or third party's identity prior to discussing any details of
the case (see DI 39567.210 and GN 00203.020).
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Provide your contact information and explain the purpose of the call.
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Explain that the claimant must comply with your initial request for evidence or action.
State that if the claimant does not comply with your initial request for evidence
or action in the additional time that you have provided, you may make a determination
based on the evidence in file, which means you may find the claimant is not disabled.
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When you need action, give the claimant 10 additional calendar days from the date
of your telephone call to comply with your initial request for action, unless there
is a good reason to give more time, and
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•
State that if the claimant does not comply with your initial request for evidence
or action in the additional time that you have provided, you may make a determination
based on the evidence in file, which means you may find the claimant is not disabled.
Document the date, the content of your conversation, and to whom you spoke, on an SSA-5002 (Report of Contact) or a Case Note in the Disability Case Processing Systems (DCPS),
and "write to" the case development worksheet (CDW).
For information on contacting a represented claimant by telephone, see DI 31001.010.
For examples of a good reason for non-cooperation, see DI 23007.001B.
When you attempt to reach one of the required contacts by telephone and they do not
answer, you may be prompted to leave a voicemail message or a message with another
party who answers the call. You must also send the intended call recipient a call-in
letter following the instructions in DI 22505.014A.2.
When leaving a voicemail message or a message with someone who is not the intended
call recipient, include only the following information in the message:
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DDS employee's name and contact information;
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We need [contact's name] to call us about [claimant's name] business with Social Security;
and
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If we do hear from [contact's name] within 10 calendar days, we may proceed to take
an action that is not favorable to [claimant's name].
When the DDS does not reach the intended call recipient, do not leave the following
information with another party or on a voicemail message:
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Any case-related identifier, such as a DCPS or EDCS number or the claimant's SSN.
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Any information referring to "disability," the type of exam or action requested, other
terminology that could suggest the claimant has a pending disability claim, or that
reveals information about the claimant's business with Social Security. This includes
referencing "Disability Determination Services" in the voicemail message.
Document the date, the content of your message, and with whom you left it, on an SSA-5002
or a Case Note in DCPS, and "write to" the CDW.
Include all of the following in the letter:
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Your contact information, date of your letter, and the method by which the claimant
should provide any requested evidence (e.g. telephone, fax, mail),
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An explanation that the claimant must comply with your initial request for evidence
or action. Identify the evidence or action that you initially requested and give the
claimant 10 additional calendar days from the date of your letter to comply, and,
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A statement that if the claimant does not comply with your initial request for evidence
or action in the additional time that you have provided, you may make a determination
based on the evidence in file, which means you may find the claimant is not disabled.