TN 4 (02-02)
GN 01020.350 Use of Form SSA-409 — General
Form SSA-409 is used to forward post-adjudicative material to the PSCs/OCO. The SSA-409 replaces the SSA-3601 (Claims Routing), for routing post-adjudicative SSA-11 change of payee packages to the PSCs.
The FO will prepare Form SSA-409 for routing post-adjudicative material to the PSCs either via mail or FAX. Do not use the SSA-409 when forwarding claims to the PSCs. In those instances, use the SSA-3601 Claims Routing form (9/98 version).
The claims representative is responsible for accurately displaying all necessary information on the SSA-409.
The FO will place the SSA-409 on top of the material to be forwarded. In preparation for paperless implementation in the PSCs, when stapling documents together, use only a SINGLE staple at the TOP in the center of the page. Before a document can be scanned into the paperless processing system in the PSCs, all paper clips and staples must be removed. To facilitate scanning and reduce paper jams, staples must be kept away from the edge of the paper. If a single staple is not sufficient to hold the material, use a large clip instead. All entries on the SSA-409 should be made in black or dark blue ink to facilitate the imaging process.