One of the primary purposes of regional instructions is to explain procedures pertaining to situations peculiar to a particular region or State. Of necessity, development can be different from region to region, particularly when developing Title XVI (SSI) claims. Regional instructions tailor general national instructions to situations unique to the region.

All regional instructions must be reviewed by Central Office (CO).

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  Use only those regional instructions approved by CO (i.e., pre- or post-review in accordance with appropriate AIMS guides) in adjudicating claims.

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  When used to resolve a material issue in Title II claims, include a reference to the regional instruction in the claims file with sufficient identifying information to distinquish which regional instruction was used. (See GN 01010.053D.)

  EXAMPLE: Kansas City Regional Supplement, March 1989, TN 1.