TN 5 (08-08)

GN 03102.425 Reconsideration Notices of Determination

A. Procedure - initial determination affirmed

1. Non-disability issue—Processing Center (PC) actions

  • Prepare Form SSA-662 (Reconsideration Determination) or the equivalent. For instructions on how to complete the SSA-662 or an equivalent, see GN 03102.450.

  • Prepare the transmittal letter in NL 00703.474 (Reconsideration Affirmation of Prior Decision).

  • Enclose the Office of Disability Adjudication and Review (ODAR) pamphlet, “Your Right to an ALJ Hearing and AC Review of Your Social Security Case” (SSA Pub 70-10281). Show as an enclosure on the transmittal letter except as provided below.

    EXCEPTION: The ODAR pamphlet is not applicable to Medicare entitlement claims denied for non-medical reasons or to foreign claimants.

  • Send the original notice of reconsideration determination to the claimant with the transmittal letter.

    NOTE: It is no longer necessary to prepare copies of the notice for the folder or the Field Office (FO) if the notice is available on the Online Retrieval System (ORS).

  • Date all copies of the notice so that it can be determined whether the time limits for filing an appeal are met, and to facilitate computing the time periods involved for reopening and revising under the rules of administrative finality.

2. Disability issue in Retirement and Survivors Insurance (RSI) case—PC actions

  • Incorporate the language furnished by the disability component in the reconsideration determination.

  • Prepare a letter instead of the SSA-662 if the disability language does not fit into the determination.

  • Follow procedures in GN 03102.425A.1. (in this section).

    NOTE: To prepare RECON SGA Affirmation notices, see DI 13010.145.

B. Procedure - initial determination reversed

1. Special determinations—PC actions

  • Prepare a Special Determination. See Special Determinations-General Adjudication, GN 01010.360. Explain the reasons and evidence used to revise the initial determination.

    NOTE: The Reconsideration Reviewer or Senior Claims Processing Specialist is responsible for adding or modifying paragraphs in the Special Determination.

  • Make a copy for the FO and the claims folder if not available on ORS.

  • Prepare a letter with the reconsideration paragraph for notices of revised or reversed determinations on other claims issues and post-adjudication issues (e.g., earnings discrepancies, work deductions).

  • Effectuate the revised/reversed determination.

2. Informing the claimant of a reversal

An award certificate or letter informs the claimant of a reversed determination on a claim previously disallowed or denied.

NOTE: Verify claimant direct deposit, address, and phone information prior to effectuating appeal decisions. Include language in the notice similar to paragraph DID029 reminding claimant to notify SSA of direct deposit and address changes.

C. Procedure for posting reconsideration determinations

After you complete the reconsideration screens, the Modernized Claim System (MCS) displays the Appeal Disposition (DISP) for completion. This screen records information on the reconsideration determination.

If the reconsideration determination is not on ORS, send a copy to the servicing FO. In addition, post a Master Beneficiary Record (MBR) special message to alert any component, including 800 number agents, of the disposition of the reconsideration request.

D. Reference

MSOM MCS 010.001 - Title II Appeals Screens-Overview


To Link to this section - Use this URL:
http://policy.ssa.gov/poms.nsf/lnx/0203102425
GN 03102.425 - Reconsideration Notices of Determination - 08/08/2014
Batch run: