Basic (03-86)
GN 03102.100 discusses the requirements for filing a request for reconsideration and includes
the policies and general procedures for developing and processing such requests. Additional
instructions for DO and DDS documentation of reconsideration requests are contained
in DI 12005.001 and DI 27001.001. If a reconsideration case is received without sufficient documentation for a sound
determination, develop additional evidence through the district office. Formal requests
for reconsideration (on Form SSA-561-U2) and informal requests are received in the
appropriate module receipts point. The Module Records Maintenance Clerk (RMC-ODO)
will process routing and transfer of requests (where claim is not ODO jurisdiction)
and association with any related claims folder. The RMC/ ODO will classify the material
(medical issue for RECONE and nonmedical for RECONR) and route to the appropriate
staffs for handling.
In the Processing Center (PC), Disability Reconsideration issues are the jurisdiction
of the Disability Review Section (DRS) Disability Examiner Consultant (DEC). Individual
Offices may issue local instructions regarding jurisdiction of reconsideration cases
which may differ from this subsection. The material is associated with the folder
in the PSC Processing Module by the Records Analysis Clerk (RAC) and routed to the
DRS.
The Reconsideration Examiner (RECONE in ODO) and Disability Examiner Consultant (DEC
in DRS) are responsible for the following:
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A.
Review of reconsideration decisions of medical/vocational and SGA issues.
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B.
Whereabouts unknown/failure to cooperate-requested evidence of current severity now
submitted.
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D.
Review of continuing disability considerations in blindness cases - title II only.
(Note under age 54 cases are handled by RECONE/ODO. Over age 54 claims are the responsibility
of the DEC/DRS.) (See DI 13010.135)
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E.
Pre-effectuation review of reconsideration determinations of continuing eligibility.
(This review must be conducted at least once every 3 years on nonpermanent impairments.)
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F.
Review of reconsideration issues on 301 (Vocational Rehabilitation) issues (this includes
reconsideration of denial by the DDS on the initial level and cessation of benefits
due to noneligibility.
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G.
Review of reconsideration determinations of cessation of benefits due to expiration
of the trial work period. (Extended Period of Eligibility (EPE) eligibility is also
determined).
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H.
Subsequent DIB or DWB claims filed after a prior Administrative Law Judge, Appeals
Council, or court decision - claimant submits new evidence (see GN 04001.001).
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I.
Reconsideration determinations of continuing disability cases when the DDS has transferred
jurisdiction under emergency clause. NOTE: DI 43520.060 contains instructions for preparation of 833 determinations.
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Jurisdiction and functions of the reconsideration review (RECONR) are found in GN 03102.175.
Reconsideration of title XVI or dual entitlement title II-XVI cases involving initial
determination of cessation (medical/vocational or blindness) are referred directly
to the Administrative Law Judge.