GN BOS03105.150 Claims Folder Reconstruction

A. General

If the current claims folder under appeal at the hearing level cannot be located within 39 days after receipt of the form HA-501-U5, or 25 days after receipt of a hearing request which is also a court case, the search should be abandoned and a proposal to reconstruct should be presented to a second level manager or above (e.g., district office manager or assistant district office manager). The regional office does not need to be notified.

If the current claim under appeal at the hearing level is located, but a prior file cannot be located, advise the hearing office (HO) of any pertinent information you have about the prior file. Do not attempt to reconstruct the prior file.

After an assistant district manager or above has authorized reconstruction, the HO must be notified and given an anticipated completion date.

The field office will take immediate action to complete all the necessary development within 15 workdays. Tight control of this development is essential to minimize further delay and hardship for the claimant.

B. Reconstruction Involving Nonmedical Issues

Their constructed material should be forwarded directly to the HO under the cover of the Reconstruction Folder Flag (Exhibit 1).

C. Reconstruction Involving Medical Issues

The field office will obtain the appropriate medical history forms, medical release forms and any other evidence that will assist the DDS with medical reconstruction. Send these forms immediately to the DDS under cover of the Request for Medical Reconstruction Flag (Exhibit 2). Do not hold medical forms until the nonmedical evidence is reconstructed.

Set a 30-day tickle, and follow-up with the DDS if the medical portion of the reconstructed folder is not received in the field office by then. Local arrangements may be made to expedite the medical reconstruction.

Hold the complete nonmedical portion of the reconstructed folder in the field office pending receipt of the medical portion from the DDS. When both parts (medical and nonmedical) are completed, forward the entire file to the HO. Annotate "Reconstructed" in bold red letters across the front of the folder jacket, and mark each piece of evidence in the folder as "reconstructed." If the claimant submits new evidence that was not contained in the original claims folder, annotate it as "New Evidence."

D. Failure to Cooperate

When a claimant fails to respond to the field office's efforts to reconstruct the folder (initial contact and follow-up at 7 days), the field office should advise the HO. In these cases, the HO will send a letter over the ALJ's signature, requesting that the claimant contact the field office within 10 days. At the end of 15 days, if the claimant still has not responded to the field office, advise the HO of the claimant's continued failure to respond. Unless the HO provides special instructions, sending what information the field office has been able to reconstruct from the office records to the HO can clear the reconstruction. All efforts to contact the claimant must be properly documented in the file.

CLAIMS FOLDER RECONSTRUCTION - EXHIBIT 1

NONMEDICAL CLAIM

RECONSTRUCTED FOLDER

TO: DATE:

(Hearing Office)

(Address)

CLAIMANT/APPELLANT NAME SSN

RECONSTRUCTION OF NONMEDICAL CLAIM

Enclosed is (RSI, DI, SSI, or CONC) reconstructed claims

folder.

FROM:

(field office contact person and title)

(field office name and code)

(field office phone number)

CLAIMS FOLDER RECONSTRUCTION - EXHIBIT 2

REQUEST FOR MEDICAL RECONSTRUCTION

TO: DATE:

(DDS)

(ADDRESS)

FROM:

(FO ADDRESS)

(UNIT Phone Number)

A REQUEST FOR HEARING WAS FILED ON BY:

(Name) (SSN)

WE HAVE BEEN UNABLE TO LOCATE THE FOLDER AND MUST RECONSTRUCT THE EVIDENCE.

PLEASE IMMEDIATELY BEGIN THE RECONSTRUCTION OF MEDICALS FOR:

(TITLE II, XVI, CONCURRENT)

ENCLOSED ARE: MEDICAL RELEASE FORMS

SSA-3368

SSA-3369

SSA-3820

OTHER

THE RECONSTRUCTION MUST BE COMPLETED WITHIN 30 DAYS OF THE DATE THAT THIS REQUEST IS RECEIVED. WHEN COMPLETED, RETURN THE RECONSTRUCTED MATERIAL TO THIS OFFICE VIA THIS FLAG.

TO:

(FO ADDRESS)

FROM:

(DDS)

MEDICAL RECONSTRUCTION COMPETED

DATE:

(DDS SIGNATURE)


To Link to this section - Use this URL:
http://policy.ssa.gov/poms.nsf/lnx/0203105150BOS
GN BOS03105.150 - Claims Folder Reconstruction - 10/02/2012
Batch run: 10/02/2012
Rev:10/02/2012