TN 13 (11-11)

GN 01010.865 Resolution of Policy Interpretation Conflicts

A. Background on the resolution of policy

From time to time, a disagreement may arise concerning the interpretation of a policy or procedure as it applies to an initial claim or post-entitlement action. When this occurs, the involved components must work together to resolve the conflict.

B. Procedure for resolving policy interpretation conflicts

1. Field Office (FO) does not agree with Processing Center (PC) development request

If the FO requests clarification of a PC development request or the information was previously furnished and is in the claims file, take the following actions.

a. Information requested is unnecessary

  1. FO Actions

    • Complete all development requested by the PC to avoid a delay in processing the claim;

    • Send a memorandum outlining the FO position to the ARC, PCO or CPS; and

    • Send a copy of the memorandum to the ARC, MOS.

  2. PC Action

    • Reply directly to the FO, agreeing or disagreeing with the memorandum and giving a full rationale.

b. FO already forwarded information

To avoid any delay in claims processing, reply to the PC and inform them when, where and what information was forwarded.

c. Restrictive evidence conditions

Take the following actions when it appears the PC is not aware that the requested development is not obtainable; would require such a delay that hardship will be incurred; or create an extremely sensitive situation:

  • Discuss the case with your Operations Supervisor; and

  • Inform the PC of the situation, discuss other equivalent evidence or request additional guidance from the PC.

2. Issue cannot be resolved between FO and PC

  • FO - Submit the issue to the ARC, MOS for the region in which the FO is located.

  • ARC, MOS - Follow the procedure outlined in GN 01010.850.

3. Rebuttal process for Quality Review Errors

Resolve any conflicts in policy or procedure interpretations between end-of-line quality reviewers and FO or PC technicians through the established error rebuttal process involving discussions between field assessment and operating component staff, the ARC, MOS or, if necessary, CO (see GN 04410.040).

4. Congressional inquiry request and action

Occasionally, the CO requests to expedite claims processing actions due to a Congressional inquiry. The immediate follow-up and response to these inquiries is essential. Congressional requests are made from the Congressional Relations Staff (CRS) within CO directly to the FO or PC by telephone, fax or e-mail. The reply will go directly from the FO or PC to CRS. If a reply is necessary, the FO or PC will include the reference symbols of the component initiating the reply.


To Link to this section - Use this URL:
http://policy.ssa.gov/poms.nsf/lnx/0201010865
GN 01010.865 - Resolution of Policy Interpretation Conflicts - 11/10/2011
Batch run: 11/10/2011
Rev:11/10/2011