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

    Line up material in items 1 through 12 with the holes on the left side and staple material between the holes.

  13. Material to be placed on top of the assembled claim. (Does not need to have holes punched.)

    1. SSA-3606 or RR-12.

    2. SSA-101-U3, SSA-3428-U2, or SSA-521

    3. Claimant's authorization to secure copy of award certificate or disallowance letter (when submitted).

    4. SSA-790IDP or prior claim message.

    5. MBR.

    6. SSA-3601 or SSA-3293.

Place the material listed in item 13 above on top of all the other material in the file and staple everything together in the upper left-hand corner. When several proofs or pieces of evidence are to be photocopied and the file is not complicated and the documents can readily be found in the file, several proofs or pieces of evidence can be photocopied on the same sheet of photocopy paper. (Example: Proof of age and primary and secondary wage evidence can be photocopied and placed in assembly order of either item.)

Place the bar code label on top.

E. Notations on completed claims file

1. Hardship cases

Identify hardship cases by marking (in red) the uppermost paper underneath the SSA-790 IDP or at the extreme top center “HARDSHIP.”

2. Congressional inquiry

If there is an unanswered congressional inquiry in file, staple Form SSA-4400 to whatever is immediately under the SSA-790 IDP.

F. Combining claims files

  1. Auxiliary (or survivor) claimant also eligible on own SSN.

    1. Assemble the material separately as listed in GN 01050.150 D. but staple the two files together with SSA-101-U3s or SSA-1000 TRs on top.

    2. All proofs relative to the RIB claim (A) and all proofs pertaining to both claims (i.e., proof of age, etc.) will, in all situations, be associated with the RIB claim (A).

  2. If the files are going to different processing centers, a copy of all necessary proofs should be with each file.

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GN 01050.150 - Preparation and Assembly of RSHI Claims Material for Transmittal to the Processing Centers - 02/12/2014
Batch run: 02/12/2014