TN 9 (09-19)

DI 13015.025 Field Office (FO) Assistance in Medical Continuing Disability Reviews (CDR) and Failure to Cooperate-Insufficient Evidence Decision (FTC) or Whereabouts Unknown (WU)

The disability determination services (DDS) or the program service center (PSC) may request FO assistance in obtaining the individual's cooperation, locating the individual, or in conducting the medical CDR interview.

A. Beneficiary or recipient does not cooperate

1. DDS requests

If the beneficiary or recipient does not cooperate with the DDS, the DDS may send an assistance request (AR) to the FO. If the beneficiary or recipient provides the requested information to the FO, return the AR with the requested information to the DDS for completion of the CDR.

If the beneficiary or recipient fails to cooperate with the FO and does not provide the requested information, document the attempts to obtain the information and return the AR to the DDS. The DDS will make a determination based on the evidence in the folder.

2. PSC requests

If the beneficiary does not cooperate with the PSC, the PSC forwards the folder to the FO. If the beneficiary does not cooperate with the FO, follow the FTC streamlined procedures in DI 13015.005 Failure to Cooperate-Insufficient Evidence Decision (FTC) Suspension Procedures for Continuing Disability Reviews (CDR)-Field Office (FO). Do not send the CDR to the DDS for a medical determination. If the beneficiary cooperates and provides the requested information, return the case to the PSC for completion of the CDR.

B. Beneficiary or recipient cannot be located

1. DDS requests

If the DDS cannot locate the beneficiary or recipient when developing the CDR, the DDS will send the file to the FO for assistance in locating the individual. If the FO cannot locate the beneficiary or recipient, and the DDS indicated that there is insufficient medical evidence to make a determination, the FO will prepare the WU determination. If the DDS indicated that the folder contains sufficient medical evidence, the FO will send the folder back to the DDS for a determination.

2. PSC requests

If the PSC cannot locate the beneficiary, the PSC forwards the folder to the FO. If the FO cannot locate the beneficiary and his or her whereabouts are still unknown, the FO accepts jurisdiction and prepares the WU determination.

C. References

DI 13005.045 Field Office (FO) Actions When the Disability Determination Services (DDS) Refers a Case to the FO

DI 28075.005 Failure to Cooperate (FTC) and Whereabouts Unknown (WU) During a Medical Continuing Disability Review (CDR)

DI 40525.001 Failure to Cooperate (FTC) and Whereabouts Unknown (WU) Cases

 


To Link to this section - Use this URL:
http://policy.ssa.gov/poms.nsf/lnx/0413015025
DI 13015.025 - Field Office (FO) Assistance in Medical Continuing Disability Reviews (CDR) and Failure to Cooperate-Insufficient Evidence Decision (FTC) or Whereabouts Unknown (WU) - 09/24/2019
Batch run: 10/21/2024
Rev:09/24/2019