Basic (04-13)

DI 31005.020 Inquiries Directed to the Disability Determination Services (DDS) from United States (U.S.) Congress Members

NOTE: Regional procedures for implementing this policy may vary.

A. DDS time frames for handling congressional inquiries

A final reply is due within 20 calendar days after the date of the acknowledgement. If the DDS cannot make a final reply within that time-period, send an interim response. Make any subsequent communication, either interim or final, within 30 calendar days after the date of the prior reply to the inquirer.

B. DDS procedures for handling congressional inquiries

1. Congressional inquiry received for a folder in the DDS

If the folder is in the DDS when you receive an inquiry, take the following actions:

a. Determination complete

  • Add a congressional inquiry flag to the folder (if not already added).

  • Reply by telephone to the requesting office. If the inquiry concerns a complicated issue and requires the folder, send the claim to regional office (RO).

  • Transmit the clearance message and provide the RO destination code. Submit the reply as soon as possible.

  • Dispose of the folder according to the instructions in DI 81020.130. For paper folders, follow the instructions in DI 32005.000.

NOTE: Advise the requesting FO if the Disability Quality Branch (DQB) sampled the claim for review.

b. Determination pending

  • Add a congressional inquiry flag, the congressional inquiry, and the interim response to the folder.

  • Expedite development and be prepared to provide a response to the RO status request.

  • Establish a diary control in accordance with the RO request. Use a 20-day diary from the date of the acknowledgement or use a 30-day diary from the date of the interim response. If the date is unknown, use the date of contact with the DDS. When the diary matures, provide the final disposition. If the DDS cannot provide a final reply, provide a substantive interim report and re-diary the claim for 30 days. Make these interim reports at 30-day intervals until claim action(s) are complete.

  • Provide a status report by telephone unless circumstances dictate otherwise.

  • Provide as much information as possible in the interim report, (e.g., specific consultative examination information, reason for any delay, folder transfer data, and the date the DDS expects to complete the actions.)

NOTE: Immediately report the transfer of folders to another location.

  • After the DDS makes the determination, inform the RO of the determination. After completing the DDS action(s), handle the claim folder and any related material according to the specific instructions the RO sent. If the DDS did not receive RO instructions, follow the standard routing guidelines.

NOTE: When preparing to forward an allowed claim to the FO, add an alert to the electronic folder with the following information: “Please call the RO immediately when all award actions are complete or when the claim is ready for clearance.” For paper folders, include that message on the SSA-408 route slip.

c. Folder transferred to another office

If you transferred the folder to another office, acknowledge the inquiry, advise the requesting FO or RO of the transfer and the current folder location. For paper folders, send inquiry material to the current folder location.

When transferring the inquiry:

  • include all available data to assist the receiving office in making a response, (e.g., copy of the acknowledgement, a copy of the SSA-831 (Disability Determination and Transmittal), destination of the folder, or other relevant data);

  • add a congressional inquiry flag to the folder (if not previously added); and

  • add an alert about the inquiry to the electronic folder.

For paper folders, transmit the inquiry via an SSA-408 as indicated below:

  • Title II claims Folder in the FO

    Route all inquiries (and related material pertaining to initial and reconsideration issues, both allowances and denials), to the Assistant Regional Commissioner for Management and Operations Support (ARC-MOS).

  • Title II Claims Folder in the PSC

    Route the inquiry and related material to the PSC with jurisdiction.

  • All Title XVI Claims and Concurrent Title II/Title XVI

    Route the inquiry and related material to the FO servicing the particular area.

2. Congressional inquiry received for a folder in another location

If the RO advises DDS of the inquiry by telephone and the folder is in another location:

  • inform the RO DDS forwarded the folder to another office, and

  • provide the RO with information on the current folder location, the release date, and the last DDS action (s) on the claim.

3. DDS receives telephone inquiry

  • If possible, provide complete information to close out the inquiry during the initial contact.

  • If you cannot provide complete information because a determination is pending, add a congressional inquiry flag to the folder; annotate the folder regarding the inquiry and process according to the instructions in DI 31005.020A.

NOTE: Respond by telephone as a final reply to congressional offices accepting or requesting this form of reply.

C. Congressional inquiry for Presumptive Disability/Blindness determinations

If you receive an inquiry on a claim when the FO previously made a presumptive disability/blindness determination, but DDS had not made a final disability determination, take the follow actions:

  • call and advise the RO of the inquiry;

  • provide the data necessary for the RO to respond to the inquiry; and

  • if necessary, diary the claim in accordance with the instructions in DI 31005.020A.

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DI 31005.020 - Inquiries Directed to the Disability Determination Services (DDS) from United States (U.S.) Congress Members - 04/15/2013
Batch run: 01/15/2019