TN 1 (06-86)
The judgments of DO personnel occurring in the adjudication process must be recorded
in sufficient detail to enable the claims authorizer or others responsible for reviewing
the claim to determine that the file is complete and that the claimant is or is not
entitled. The protection of the rights of the claimant and the proper conservation
of the trust funds depends on the completeness and integrity of the claims file. The
file must be able to stand up under the scrutiny of reconsideration hearing, appeal,
audit, congressional inquiry, and judicial review.
Under DO Final Authorization (DOFA), the DO decision may be final because only a small
random sample percentage of cases is reviewed again by the processing center. While
accuracy is stressed for those claims cleared in the DO final authorization process,
it is well to remember that the accuracy of all other DO claims is equally important.