Quality review components must use the procedures outlined below when clarification
of disability program or quality review policy is necessary, at any time, during the
quality review process.
If policy and procedural guidelines or Program Operations Manual System (POMS) instructions
do not clarify the disability program or quality review policy issue requiring resolution,
quality review components must refer the case to the Division of Disability Quality
(DDQ), in the Office of Quality Review (OQR), using the process described below.
NOTE: Under no circumstances should a quality review component submit policy issue referrals directly
to the Office of Disability Policy (ODP) or any other central office component.
When a quality review component needs to request policy or procedure clarification,
the quality review component will submit their question(s) using the Policy Clarification
and Field Site Assistance Form located on the Office of Quality Review (OQR) Field
Site Home SharePoint.
The information needed to submit a question includes:
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the subject or topic of the question,
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the primary requestor's contact information,
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the type and level of the case associated with the question,
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the social security number associated with the case,
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the specific policy issue or question,
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the proposed resolution, and
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any applicable policy or procedure references.
Once a quality review component submits a question using the designated submission
form, a notification e-mail will automatically be sent to the ^DCARO OQR Policy Questions
mailbox.
The mailbox leads in DDQ will assign the question to a DDQ staff member(s) and change
the status on the submission form to "Assigned".
NOTE: The individual designated as the "Primary Requestor", and all other individuals
listed in the "Notify Other Users" field on the submission form, will receive automatic
e-mail notifications upon initial submission of a question, when a question is referred
to another component, and when the response to the question is completed by DDQ staff
members.
For pending cases, the assigned DDQ staff member(s) will respond to the submitted question in:
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two business days, if the question can be answered with DDQ input alone, or
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seven business days, if the question requires multi-component collaboration and input.
For closed cases, the assigned DDQ staff member(s) will respond to the submitted question in:
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five business days, if the question can be answered with DDQ input alone, or
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fourteen business days, if the question requires multi-component collaboration and
input.
If the assigned DDQ staff member(s) is unable to provide a response within the allotted
time, that staff member will provide a status update, via e-mail, to all of the quality
review component staff designated on the original submission form and send a copy
of the e-mail to the ^DCARO OQR Policy Questions mailbox.