TN 11 (09-87)

RM 03844.047 Referring Coverage Cases to the Office of Income Security Programs (OISP)

1. A. 

   Cases involving one or more of the following conditions will require an OISP decision:

   1. 1. 

      Coverage problems exist in which a determination cannot be made on the basis of existing instructions.

   2. 2. 

      A disagreement exists relative to a ruling of IRS or RRB.

   3. 3. 

      Doubt exists that the proper determination was made.

   4. 4. 

      Direction is needed to handle the question raised.

   5. 5. 

      Cases involving employment with a Federal agency or instrumentality where development is necessary.

      NOTE: When the conditions in 3. or 4. above occur, prepare the determination per the instructions in RM 03844.060 (as believe it should be made) and submit it to OISP.

2. B. 

   All cases falling under A. above must be transmitted to OISP by Form SSA-4597 U3, Record of Material Referred To.

3. C. 

   Prior to releasing any case to OISP, ensure that the following actions have been taken:

   1. 1. 

      Make sure all scouting pertinent to resolving the case has been completed.

   2. 2. 

      Be sure you have analyzed the case thoroughly and have weighed all the facts properly.

   3. 3. 

      Give the reconsideration specialist or technical assistant an opportunity to carefully consider and approve your decision.

   4. 4. 

      Prepare your memorandum to OISP.

   5. 5. 

      Remove the pertinent material from the ED folder and attach it (along with any determination prepared) to the outgoing memorandum.

   6. 6. 

      Retain a copy of all pertinent material, memorandum, and the determination (if any) in the ED folder.

   7. 7. 

      Complete the disposition block of the ED folder to show your initials, mod, date and “OISP—Pending.”

   8. 8. 

      Clip the material being sent to OISP to the outside of the ED folder.

      NOTE: Followup with OISP if the case has not been returned within 60 calendar days.

4. D. 

   When the case is returned from OISP containing coverage decisions or approval, take one of the following appropriate actions:

   1. 1. 

      If further development with the FO is required, prepare an SSA-5533 U4 per RM 03803.055B.

   2. 2. 

      If necessary, prepare or revise a special determination per RM 03844.060.

   3. 3. 

      If OISP agrees with any previously prepared special determination (see note in A. above), apply the procedures in RM 03844.060 C.-G.