Effective Dates: 04/01/2016 - Present Previous | Next

Last Update: 4/1/2016 (Transmittal I-3-134)

HA 01320.011 Referral to the Medical Support Staff (MSS)

Renumbered from HALLEX section I-3-2-11

A. When to Refer to a Case MSS

The analyst may refer a case to the MSS in the Office of Appellate Operations when the Appeals Council (AC) needs:

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    Medical advice about or an interpretation of clinical findings or test results in the medical evidence;

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    Medical advice about conflicts in the medical evidence;

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    Medical advice about specific testing;

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    Medical advice regarding multiple consultative examination (CE) findings;

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    Medical advice on the type of CE that needs to be requested on remand;

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    Medical advice as to whether the severity of the claimant's impairment(s) meets or equals a listing; or

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    Medical assessment of the claimant's ability to perform work-related activities.

B. How to Refer a Case to MSS

The analyst will create a referral in the Office of Appellate Operations Case Processing System (OAOCPS) and route to their branch chief. See the OAOCPS Business Process and the OAO Practices and Applications (PANDA) for instructions on completing the referral and specific referral requirements.

The branch chief will review each referral to ensure that the analyst properly completed the referral before forwarding the request to MSS.

NOTE: 

The branch will hold the processing of the case until MSS responds to the request.

C. Receipt of an MSS Report

1. Receiving the Report

The AC only exhibits an MSS report if the AC issues a decision that relies on the report. Therefore, until the AC evaluates the report and determines the appropriate course of action, the reports are associated with the record as follows:

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    In electronic cases, MSS will upload the report to the Private section of the electronic folder.

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    In paper cases, MSS will route the report to the analyst in a private AC paper folder.

2. Evaluating the Report

Analysts must keep in mind that MSS reports are advisory in nature. The analyst must consider the entire file, including MSS reports, in making a recommendation to the AC.

3. Proffering the Report

When the AC intends to issue a less than fully favorable decision that will rely on an MSS report, the AC must proffer the MSS report, as set forth in Hearings, Appeals and Litigation Law (HALLEX) manual HA 01320.016. In electronic cases, if the B member adjudicator agrees with the recommendation, the B member will move the MSS report from the Private section of the electronic folder to the F section.

4. Exhibiting the Report

When the AC relies on an MSS report, the AC must exhibit the report. However, when the AC does not rely on the report, the AC does not exhibit the report or associate the report with the record.

To exhibit an MSS report:

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    In electronic cases, if the B member adjudicator agrees with the recommendation to issue a decision relying on an MSS report, the B member will move the MSS report from the Private section of the electronic folder to the F section, or, if the MSS report was proffered, ensure that the report was already moved to the F section. The B member will then exhibit the report and confirm that the exhibit number cited in the draft decision matches the actual exhibit number.

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    In paper cases, the analyst will add the paper copy of the MSS report to the F section of the folder and add the report to the exhibit list at the time the AC decision is drafted.

To Link to this section - Use this URL:
http://policy.ssa.gov/poms.nsf/lnx/2501320011
HA 01320.011 - Referral to the Medical Support Staff (MSS) (I-3-2-11) - 04/01/2016
Batch run: 06/11/2025
Rev:04/01/2016