The review component returns all cases with group I decisional deficiencies to the
adjudicating component for correction.
The review component will:
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•
annotate all of the adjudicating component’s original determination and medical assessment
forms, as well as notices, in the CEF, as “Do Not Process” or “Do Not Release”, as
applicable,
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•
code the deficiency in the case processing system,
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•
notify the adjudicating component, via an SSA-1774-U5 Request For Corrective Action,
to explain why the determination is not policy compliant and request the adjudicating
component to change the determination,
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•
route the case to the adjudicating component for correction, as a controlled return,
and
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•
follow-up with the adjudicating component in 30 days if the corrected determination
has not been returned to the review component.
NOTE: All of the adjudicating component’s original determination and medical assessment
forms, as well as notices, must remain in the CEF as part of the audit trail.