The FO is responsible for obtaining and securing the Title XVI medical folder(s) and
the Processing Center (PC) is responsible for obtaining and securing the Title II
or the Title II portion of a concurrent Title II/XVI medical folder(s) so the continuing
disability review (CDR) can be initiated. Ultimately the FO is responsible for reviewing
the folder received to determine whether the necessary prior medical information is
in the file. If multiple folders are received, the FO needs to examine each file to
determine which folder contains the needed medical evidence. See DI 13015.080 if no medical evidence is received.
Regardless of title, if the DDS finds the beneficiary/recipient is not currently disabled (see DI 13015.070), the DDS will return the file to the FO to prepare a replacement folder under the full reconstruction process (see DI 13015.090). The replacement folder must contain sufficient medical evidence/leads for the DDS
to complete a medical improvement review standard (MIRS) determination.
Studies have shown when every effort is made to find a lost folder, in most cases
the folder is found.
The instructions in this subchapter discuss the FO actions in the medical review process.