TN 56 (01-16)

DI 11010.620 Request for Additional Field Office (FO) Development before Determination by the Disability Determination Services (DDS) or Processing Center Disability Processing Branch (PC-DPB))/Disability Processing Units (DPU)

The DDS or federal disability component may refer a case back to the FO for additional development before making a determination on a disability claim or continuing disability issue.

A. Development request from DDS

1. DDS procedure

When the DDS needs additional development from the FO, the DDS will:

  • Send an electronic assistance request (AR) for certified electronic folders (CEFs). The request generates to the designated FO’s Electronic Disability collect System (EDCS) action page.

  • Request FO assistance by telephone or use the SSA-883-U3 (Request for Evidence of Assistance (Disability Case) for more complex development issues.

Send follow-ups through the electronic AR function. If the case is a paper claim, follow-up using these procedures:

  • Telephone every 15-calendar days from the date of the original request date; and

  • Conduct further follow-ups, if needed, in 10-calendar day intervals.

2. FO procedure

DDS ARs require priority handling because DDS cannot complete adjudication without the requested development.

a. Electronic request

Electronic AR request from DDS will come through the EDCS action page and propagate to the designated Claims Representative (CR) list for action. Once all actions are completed, upload all documents to the CEF and update the EDCS action page showing that the electronic AR is complete. For more information on electronic ARs, refer to DI 81020.100F.

b. Paper request

If the electronic folder is not available, the FO will use the reverse side of the SSA-883-U3 to route the completed development to the DDS unless DI 11010.635 applies.

B. Development requests from PC-DPB/DPU

1. PC- DPB/DPU procedure

When the PC-DPB/DPU request development assistance use the following procedure:

  • The PC-DPB/DPU will follow electronic AR procedures in DI 81020.100 Electronic Assistance Request (AR). If the case is paper use form SSA-5526-U3 (Request for Assistance - Disability) to request FO development before making a determination on a disability claim or continuing disability issue.

  • If DDS action is required, follow the standard electronic AR request procedures. If the case is paper, PC-DPB/DPU will staple the original SSA-5526-U3 form to the outside of the folder jacket along with the original of Form SSA-847-U3 (SSA Request for Case Action) and address it to the DDS.

  • For all CEF, the FO will submit documentation into the proper sections in the electronic folder. Once development is complete, update the electronic Assistance Request (AR) and submit the claim back to PC-DPB.

NOTE: PC-DPBs providing workload assistance to process claims, use the electronic ARs when requesting a consultative examination (CE).

2. FO procedure

a. Electronic AR

If the FO receives an electronic AR, the FO transmits the completed development electronically to the DDS. Once submitted an alert generates to the examiner in eView advising of completion.

b. Paper assistance request

When returning paper ARs use the following procedures:

  • If the FO needs to return the completed development to the PC-DPB/DPU, use the reverse side of the original SSA-5526-U3 as a transmittal for the completed material. Prong file the development on the right side of the claims folder, and forward the folder with the development request.

  • If the FO needs to forward the completed development to the DDS, prong file the SSA-5526-U3 with the developed material on the right side of the claims folder and forward to the DDS using the original copy of the PC-DPB/DPU prepared SSA-847-U3 as a transmittal.

NOTE: Do not convert an electronic request to a paper request.


To Link to this section - Use this URL:
http://policy.ssa.gov/poms.nsf/lnx/0411010620
DI 11010.620 - Request for Additional Field Office (FO) Development before Determination by the Disability Determination Services (DDS) or Processing Center Disability Processing Branch (PC-DPB))/Disability Processing Units (DPU) - 01/28/2016
Batch run: 01/28/2016
Rev:01/28/2016