TN 35 (09-12)

GN 00203.010 Conducting Interviews under Difficult Situations

A. Interviewing people who are blind or visually impaired

Apply the special provisions for interviewing people who are blind or visually impaired under title II and title XVI, as outlined in DI 11005.070.

B. Interviewing people who are terminally ill

  1. Identify a claim as a potential terminal illness (TERI) case if it meets the following criteria:

    • an allegation (e.g., from the claimant, a friend, family member, doctor or other medical source) that the illness is terminal;

    • an allegation or diagnosis of acquired immune deficiency syndrome (AIDS);

    • the person is registered in Medicare-approved hospice or receives hospice care (e.g., in-home counseling or nursing care); or

    • the illness meets the list of descriptors outlined in DI 11005.601C.

  2. Take the following actions when interviewing people who are terminally ill and may be emotionally upset or under stress during the interview:

    • apply active listening skills;

    • determine the best method of conducting the interview (i.e., face-to-face, self-help (e.g., Internet), telephone, or a combination of these methods);

    • confer with the physician or medical staff to arrange for a convenient time if the person requests a personal contact either in the hospital or hospice; and

    • determine if the person requires third party assistance if we make the personal contact at his or her home.

  3. Follow these additional procedures for processing TERI claims where applicable:

C. Interviewing people with contagious diseases

This subsection addresses health concerns that involve daily public contact and exposure to contagious diseases like tuberculosis (TB).

  1. Notify a member of management immediately if you discover that a claimant has a contagious disease. For example, the interviewee may have active TB, which is not treated or inadequately treated. For more information on TB, see the Centers for Disease Control and Prevention website.

  2. Always treat the public compassionately, act professionally, and do not discriminate for any reason.

  3. Make a reasonable effort to reduce the public health risk involved in transacting business in the field office (FO).

  4. Inform members of the public with contagious diseases (e.g., diagnosed with untreated or inadequately treated active TB or the H1N1 virus) of their options for conducting business with us. Inform him or her that the following options are available:

    • calling the National 800 number,

    • scheduling interviews by telephone, and

    • using Internet services.

If the person wants to conduct business by telephone, but does not have a phone, attempt to establish a third party contact.

D. Interviewing people with behavioral problems

Some interviews will involve people who react emotionally to stressful situations or otherwise show signs of behavioral problems. Following are examples of some of these signs and ways to help people communicate during the interview.

1. Common Signs of behavioral problems

Some people may exhibit one or more of the following signs:

  • disorientation,

  • decreased level of alertness,

  • delusions,

  • hallucinations,

  • fearfulness,

  • mistrustfulness,

  • obsessions,

  • compulsions,

  • reduced ability to pay attention and concentrate, or

  • unstable mood and behavior (such as appearing tearful or poor impulse control).

2. Interview techniques

When you observe any of these signs, you may need to:

  • use good listening skills;

  • speak simply, slowly, clearly, calmly, and acceptingly;

  • avoid confrontations;

  • reduce distractions in the interviewing environment as much as possible;

  • provide relaxed responses, even to odd or peculiar questions or behaviors; or

  • make all reasonable efforts not to make the person feel uneducated or lacking or to otherwise prompt the person to respond defensively or in anger.

When you are interviewing severely distressed people, you may need a third party to participate in your interactions with him or her (for example, a family member, friend, representative payee, or someone suggested by the person you are interviewing).

If you suspect that the behavior problems may be a result of a mental impairment, refer to DI 11005.076.

E. References

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GN 00203.010 - Conducting Interviews under Difficult Situations - 09/18/2012
Batch run: 09/18/2012