GN 04440.000 Federal Quality Review of Disability Determinations

Subchapter Table of Contents
Section Latest
Transmittal
QUALITY REVIEW PROCESS AND STANDARD
GN 04440.001List of AcronymsTN 8 06-04
QUALITY REVIEW PROCESS AND STANDARD
GN 04440.002The Quality Review (QR) ProcessTN 13 12-10
GN 04440.003Explanation of Quality Review (QR) TermsTN 13 12-10
GN 04440.004Quality Review ExclusionsTN 22 08-14
GN 04440.005Types of Federal Quality Reviews (QR)TN 13 12-10
GN 04440.006Quality Reviewer ResponsibilitiesTN 13 12-10
GN 04440.007Quality Review (QR) StandardTN 13 12-10
GN 04440.008Quality Review Process (Initial Level Claims)TN 24 09-14
GN 04440.009Fraud or Similar Fault (FSF) Procedures for Quality ReviewersTN 26 03-15
GN 04440.010Certified Electronic Folder (CEF)TN 13 12-10
GN 04440.015Federal Quality Review (QR) of Certified Electronic Folder (CEF) CasesTN 13 12-10
GN 04440.020The Scope of Quality Review (QR) for Certified Electronic Folder (CEF) CasesTN 13 12-10
GN 04440.025Processing Concurrent Claims or Split Samples in Certified Electronic Folder (CEF) CasesTN 13 12-10
GN 04440.030Cases Involving Special Notice Options (SNO)TN 17 10-11
GN 04440.110Defining the Probability of Reversal (POR) Rule and Classifying Documentation DeficienciesTN 16 04-11
GN 04440.112When You Cannot Use the Probability of Reversal (POR) RuleTN 16 04-11
GN 04440.114Applying the Probability of Reversal (POR) RuleTN 16 04-11
GN 04440.116Guidelines for Making Probability of Reversal (POR) DeterminationsTN 16 04-11
GN 04440.118Substitution of Judgment (SOJ) in the Quality Review (QR) ProcessTN 16 04-11
GN 04440.119Determining Whether Substitution of Judgment (SOJ) is at IssueTN 16 04-11
GN 04440.120Criteria for Classifying Work Activity Documentation DeficienciesTN 16 04-11
GN 04440.123High- and Low-Impact Grace PeriodsTN 13 12-10
GN 04440.125Recording DeficienciesTN 13 12-10
GN 04440.130Medical Review PolicyTN 29 01-17
GN 04440.135Medical Review ProcessTN 13 12-10
GN 04440.140Vocational Review PoliciesTN 23 09-14
GN 04440.150Processing Correct Disability CasesTN 21 02-14
CORRECTIVE ACTION - GENERAL
GN 04440.201General Rules for Routing and Correcting Deficient CasesTN 25 12-14
GN 04440.202Controlling Deficient Disability CasesTN 21 02-14
GN 04440.203Second ReturnsTN 8 06-04
CORRECTIVE ACTION - GROUP I DEFICIENCIES
GN 04440.204Correcting Group I Deficiencies - GeneralTN 8 06-04
GN 04440.205Correcting Group I Decisional Deficiencies Involving OnsetTN 8 06-04
GN 04440.206Correcting Group I Medical Documentation Deficiencies Involving Onset – Title II Only CasesTN 8 06-04
GN 04440.207Correcting Group I Medical Documentation Deficiencies Involving Onset – Concurrent Title II/Title XVI CasesTN 8 06-04
GN 04440.210Correcting Group I Substantial Gainful Activity (SGA) Decisional DeficienciesTN 8 06-04
GN 04440.211Correcting Group I Work Activity Procedural Documentation DeficienciesTN 21 02-14
GN 04440.212Routing Chart -- Group I Work Activity DeficienciesTN 8 06-04
CORRECTIVE ACTION - GROUP II DEFICIENCIES
GN 04440.216Correcting Group II Deficiencies - GeneralTN 8 06-04
GN 04440.217Corrections to SSA-831-C3/U3TN 8 06-04
GN 04440.218Correcting Group II Cessation Date DeficienciesTN 8 06-04
GN 04440.219Correcting Group II Ending Date DeficienciesTN 8 06-04
GN 04440.220Correcting Group II Onset Date Decisional DeficienciesTN 8 06-04
GN 04440.221Exhibit-Routing Chart of Group II Decisional DeficienciesTN 8 06-04
GN 04440.222Correcting Group II Onset Date Documentation Deficiencies Pre-EffectuationTN 8 06-04
GN 04440.223Correcting Group II Onset Date Documentation Deficiencies Post-Effectuation - Title II Only Initial CasesTN 8 06-04
GN 04440.224Correcting Group II Onset Date Documentation Deficiencies Post-Effectuation - Title II Only Reconsideration CasesTN 8 06-04
GN 04440.225Correcting Group II Onset Date Documentation Deficiencies Post-Effectuation - Concurrent Title II/Title XVI CasesTN 8 06-04
GN 04440.226Routing Chart – Group II Onset Date Documentation Deficiencies –Post-Effectuation CorrectionTN 8 06-04
GN 04440.227Group II Onset Date Deficiencies Involving A ReopeningTN 8 06-04
GN 04440.228Correcting Group II Work Activity Documentation DeficienciesTN 21 02-14
GN 04440.230Technical Corrective Actions (TCAs) in GeneralTN 13 12-10
GN 04440.23112-Month Medical Evidence of Record (MER) Technical Corrective Action (TCA)TN 13 12-10
GN 04440.232Decision Basis Code Technical Corrective Action (TCA)TN 13 12-10
GN 04440.233Diary Entry Technical Corrective Action (TCA)TN 19 02-13
GN 04440.234Medical and Vocational Documentation Technical Corrective Actions (TCAs)TN 13 12-10
GN 04440.235Correcting Other Technical Corrective Actions (TCAs)TN 21 02-14
GN 04440.236Notices Requiring a Technical Corrective Action (TCA)TN 17 10-11
GN 04440.237Determination Forms Technical Corrective Action (TCA)TN 13 12-10
GN 04440.238Correcting Incorrect or Missing Residual Functional Capacity (RFC) Assessment and Psychiatric Review Technique Forms (PRTF)TN 13 12-10
GN 04440.239Correcting Cases with Other Missing or Incorrect FormsTN 13 12-10
GN 04440.240Mental Impairment Case Technical Corrective Action (TCA)TN 13 12-10
GN 04440.241Correcting Unsigned Consultative Examination (CE) ReportsTN 13 12-10
GN 04440.242Correcting Cases with Essential Evidence that is Missing or IllegibleTN 13 12-10
GN 04440.243Correcting Cases with a Capability Development Technical Corrective Action (TCA)TN 13 12-10
GN 04440.244Policy Requirements for Assuming JurisdictionTN 15 02-11
GN 04440.245Assuming Jurisdiction OverviewTN 27 04-15
GN 04440.247Reviewing Informal Remand CasesTN 15 02-11
GN 04440.250Reviewing Cases That Have Been Inadvertently EffectuatedTN 15 02-11
GN 04440.300Trailer Material and Update after Transfer (UAT) AlertsTN 15 02-11
GN 04440.310Disability Hearing Unit (DHU) Jurisdiction CasesTN 15 02-11
GN 04440.320Policy Issue ReferralsTN 15 02-11
GN 04440.401Resolving Deficiency Disagreements between the Adjudicating and Reviewing ComponentsTN 28 09-16
GN 04440.405Request for Program Consultation (RPC) Process DescriptionTN 28 09-16
GN 04440.410The Office of Quality Review (OQR) Rebuttal ProcessTN 28 09-16
GN 04440.415Policy Issue Referrals in Rebuttal Cases Using the Office of Quality Review (OQR) Rebuttal ProcessTN 28 09-16
GN 04440.425Rescinding or Correcting DeficienciesTN 28 09-16
GN 04440.501Completion of the SSA-1774-U5, Request for Corrective ActionTN 20 04-13
GN 04440.505Completing the SSA-847-U3, SSA Request for Case ActionTN 14 12-10
GN 04440.510Completing the SSA-5524-U3, Request for AssistanceTN 14 12-10
GN 04440.520Completing the SSA-3023-F3, Medical Consultant's Review of Psychiatric Review Technique FormTN 14 12-10
GN 04440.524Completing the SSA-392, Medical Consultant's Review of Physical Residual Functional Capacity AssessmentTN 14 12-10
GN 04440.525Completing the SSA-392-SUP, Medical Consultant's Review of Mental Residual Functional Capacity AssessmentTN 14 12-10
GN 04440.901SSA-1774-U5 - Request for Corrective ActionTN 6 05-95
GN 04440.905SSA-1774A-U5 - Continuation - Request for Corrective ActionTN 6 05-95
GN 04440.910SSA-847-U3 - SSA Request for Case ActionTN 6 05-95
GN 04440.915SSA-5524-U3 - Request for AssistanceTN 14 12-10
GN 04440.916Form SSA-1047 (Vocational Consultant Case Analysis)TN 23 09-14
GN 04440.920Deficiency Return FlagTN 6 05-95
GN 04440.925SSA-3023 - Medical Consultant's Review of Psychiatric Review Technique FormTN 6 05-95
GN 04440.929SSA-392 - Medical Consultant’s Review of Physical Residual Functional Capacity AssessmentTN 9 03-05
GN 04440.930SSA-392-SUP - Medical Consultant's Review of Mental Residual Functional Capacity AssessmentTN 6 05-95
GN 04440.935Review and Adjudicating ComponentsTN 14 12-10
GN 04440.936State-Specific Instructions for Acquiescence Rulings (AR)TN 14 12-10
GN 04440.940Payment Effectuation FlagTN 8 06-04
GN 04440.941Chart for Determination Forms Prepared or Corrected in the Review ComponentTN 14 12-10
GN 04440.945Definitions of Group I Deficienci