TN 19 (05-07)
These instructions do not in any way modify or supersede established policies governing
the acceptability and evaluation of evidence/documents in the adjudicative or post-adjudicative
process as set forth in GN 00301.015.
Advise the claimant:
To submit the original document or a copy certified by the record custodian.
To write his/her name and Social Security claim number on the back of the document
for identification purposes.
That no benefits can be approved for payment until SSA reviews the evidence.
That his/her document will be returned after it is certified for SSA's records.
See GN 00301.185 to assist the individual in obtaining the evidence. Adapt the instructions for local
If the individual will need special help that the PC cannot provide, request FO assistance
per GN 01070.400A.
Give the specific PC mailing address, your MOD/Unit number, name or initials and position
Tell him/her to mark the envelope “To Be Opened By Addressee Only” or “Do Not Open
in Mailroom” (depending on local procedure).
Ask him/her to repeat the mailing information back to you to ensure its accuracy.
Prepare And Mail The letter.
List the evidence requested and any other information that will be helpful to the claimant/individual
(where the evidence may be obtained, how to request it, etc.).
Explain the reason for requesting the evidence.
Show an enclosure, if appropriate.
If the claimant/beneficiary is being asked to obtain a birth, marriage or school record
from the custodian of record, prepare the appropriate letter as shown in GN 00301.195.
A copy of any notice prepared in Aurora will be stored on SSA’s Online Retrieval System.
If for some reason the notice is not prepared in Aurora, a copy should be printed
and stored in the manner described in GN 01070.315B.4.
Include a pre-addressed non-postage paid reply envelope as described in GN 01070.320A.2.a.
30 calendar days if the evidence is in the individual's possession.
45 calendar days if the evidence must be obtained.
At the end of the diary period determine if:
The evidence has been sent and the diary should be extended; or
Contact with the FO should be made per GN 01070.400.
Follow the rules for electronic evidence documentation and retention in GN 00301.286 and either annotate the EVID screen to record the evidence electronically or, if
the evidence is exempted from recordation on EVID per GN 00301.286D.4, have a copy of the evidence scanned into the Paperless folder (and/or the non-disability
repository when it becomes available). Documents relating to WC/PDB or a disability
issue should also be faxed into the electronic disability folder, if present. If the
paper claims folder is present at the time the document is received, also place a
properly certified photocopy of the evidentiary document in it.
NOTE: Only an authorized employee
can certify the document. (See GN 00301.090.)
Return the claimant/beneficiary's document promptly.
If the problem cannot be resolved by telephone, forward the document to the FO with
the necessary background information for resolution. Diary for a response (see GN 01070.440 for diary time frames.)
Explain that we cannot make a decision without reviewing the evidence.
Tell the claimant/beneficiary to take the evidence to the nearest SSA field office
(FO) and ask the FO to make a certified copy of the evidence and mail or fax it to
Ask for the name and/or address of the FO to which he/she will be going and then notify
the FO by telephone or MDW (see GN 01070.400) that the individual will be coming in.