Quality Review (QR) uses the SSA-93 (Quality Review Feedback Report), to notify the Field Office (FO) and the Office of the Regional Commissioner (ORC) of findings that identify payment errors and informational items that require FO action but may not affect payment.

The purpose of the rebuttal procedure is to resolve case-related disagreements between FOs and QR components. This process resolves issues systematically and ensures affected SSI records are correct. We encourage informal communications between QR and operating components to expedite resolution.

The FO may rebut a cited deficiency only if it meets the criteria for a rebuttable issue outlined in QR 04461.030C. The FO may contact QR to informally resolve other issues. To submit a rebuttal, the FO goes to the SSA-93 website within 45 days of the date QR transmitted the SSA-93 and:

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  Selects Rebuttal Request Sent to QR in the Respond To SSA-93 area of the SSA-93 website;

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  Describes the reason for the rebuttal in the comments area;

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  Scans all supporting material into the electronic folder and clearly indicates the location in the comments area of the website; and

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  Updates the SSA-93 Quality Review website to notify QR of the rebuttal request by automated email.

Delay corrective action only on the contested deficiencies pending final resolution. Correct all non-disputed deficiencies.

To rebut the following types of deficiencies cited by QR, the FO may use the formal rebuttal process in QR 04461.030E through QR 04461.030F:

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  Stewardship Review: Payment deficiencies of any dollar amount that affect the sample period's payment, and

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  SSI Transaction Accuracy Review (SSI TAR): Payment deficiencies in the review period of $5 or more or dollar deficiencies of any amount resulting in ineligibility for all months in the review period.

QR identifies non-payment and informational issues on the SSA-93. Do not forward protests of these items through the rebuttal process.

The following deficiencies cited by QR are not subject to the rebuttal process.

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  All non-payment deficiencies;

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  All informational items;

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  SSI TAR dollar deficiencies that affect the amount of the sample period's payment by less than $5; or

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  Any deficiencies cited on Special Studies.

If the FO disagrees with QR on any of the above, they must contact the QR office that cited the issue and resolve informally. If necessary, QR revises the Quality Review (QR) system to reflect the informal decision. The FO must document the SSA-93 website by selecting the “Other” option and explaining the issue in the comments area if the informal decision is that corrective action is unnecessary or will differ from the original QR findings.

When the QR field site receives the rebuttal request, they review it to determine the appropriate action.

When the QR field site affirms all or part of the original determination, they send an email via the SSA-93 website to DT16QSE with the rationale for the affirmation annotated in the comments area of the SSA-93 website.

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  If a policy issue is not involved, DT16QSE reviews the rebuttal and issues a final decision within a targeted timeframe of 15 days.

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  If the rebuttal involves a policy issue, DT16QSE refers the case to the Office of SSI and Program Integrity Policy (OSSIPIP) in the Office of Income Security Programs (OISP) within 15 days of the date of the QR field site email. This process is known as “Request for Policy Review (RPR).”

Within a targeted timeframe of 15 days from the date of referral, the OISP/OSSIPIP policy team sends a proposed decision to DT16QSE or initiates inter-component discussion with DT16QSE. QR grants extensions if needed.

DT16QSE reviews OISP/OSSIPIP’s decision and either concurs or requests further discussion. When OISP and QR agree on the proposed decision, OISP/OSSIPIP renders a final written decision. QR then updates the decision on the SSA-93 website and generates an automated email to the FO, ORC, and the reviewing QR field site.

After resolution of the rebuttal, the FO makes any applicable corrective action inputs to the Supplemental Security Record, initiating further development as required. It is not necessary to notify QR. When all actions are complete (including disability decisions, development, etc.), the FO updates the SSA-93 Quality Review website. The ORC monitors FO completion of SSA-93s corrective actions.