TN 1 (06-86)

GN 01050.150 Preparation and Assembly of RSHI Claims Material for Transmittal to the Processing Centers

A. Material to include:

  1. Include all essential material—this includes more than evidence that establishes facts or tends to back up statements. It means material required or suggested by POMS instructions including any material that conflicts or disagrees with the application or other evidence. (See also GN 01050.240)

  2. Ask the CR if you have any question as to whether or not material should be included.

B. Material not To be sent to PSC

  1. Notes, carbon copies of R/C's or rough drafts made for the convenience of the DO.

  2. Blank forms or questionnaires and routine correspondence with claimants or employers.

  3. Extra copies of RC's.

  4. Envelopes not required to establish a filing date or necessary for other documentation purposes.

  5. Copies of routine development correspondence with claimants or third parties. (This does not include correspondence which might be considered an application or important to any determination).

  6. Route slips, such as forms SSA-408, etc.

  7. Multiple photocopies of proofs.

  8. RCs recording follow-up efforts made for evidence that is now in the claims folder or letters requesting evidence now in file.

  9. Carbon copies of multiple-page forms.

  10. Photocopies of material already in file.

  11. Computer output material on the right side of the folder which has no future documentation value. In title II claims retain only the latest computer output (such as MBR, ROAR, etc.) in file.

  12. Signed authorization forms (such as the SSA-827, SSA-4641-U2, SSA-8510, etc.), which have not been used.

C. Preparing material for the claims file

  1. Review each piece of material for completeness and make sure the NH's SSN is shown.

  2. All original documents that are transmitted with the file but which must later be returned to the claimant should be inserted in an envelope and marked “return document to claimant.”

  3. Punch holes in the left margin of all material listed in GN 01050.150 D. items 1-11, not previously punched.

    1. The hole should be punched to line up with those prepunched on application and other forms.

    2. Care should be taken to avoid obliterating any information with the holes.

    3. If it is impossible to punch holes without obliterating some information, either insert the material in an envelope and mark “to be retained in file,” or attach it securely to a regular 8 1/2 by 11 piece of bond paper and punch holes in the paper.

  4. Remove any staples that would impede the review of the material.

  5. Complete any explanation of special actions or other information on a Report of Contact. If claim is being forwarded unadjudicated the reason should be explained on a Report of Contact or Form SSA-3601.

D. Assembly of RSHI claims material

Assemble the material in the following order from bottom to top:

  1. Application forms. Put the lowest numbered application on the bottom, second lowest next, etc. (Inc. SSA-3, 15,&25).

  2. SS-5, or extract printouts, if applicable.

  3. Proof of death.

  4. Proof of age.

  5. Other proofs such as SSA-760-F4, SSA-11 BK, SSA-783, etc.

  6. Questionnaires.

  7. Claims correspondence and claimant's reports. Place in chronological order with the most recent on top.

  8. Free-Format Earnings Record - include any attachments such as OCRO scouting, RR-90 (if RR involved). Place minicertified earnings record here if the minicertified rather than the free-format is received. Also place ONBE or OFBE here if a benefit estimate earnings record was obtained.

  9. All other primary and secondary wage evidence including:

    1. SSA-7011, SSA-1002, W-2.

    2. SSA-768

    3. Self-employment tax returns and/or SSA-767.

    4. SSA-654-U4.

    5. Any other secondary evidence.

  10. Special determinations.

    1. SSA-553.

    2. SSA-7000-U5 or SSA-7010-U5. Include the SSA-3565 with the SSA-7010-U5.

    3. SSA-4500-U6

    4. SSA-2038-F3, Date of Birth Determination, or similar form, if required.

  11. SSA-5002 with any necessary explanations.

  12. SSA-671