TN 13 (12-10)

GN 04440.006 Quality Reviewer Responsibilities

Federal quality reviewers are responsible for the correctness of quality reviews (QRs) and for the correctness of the disability determinations they review. Quality reviewers’ responsibilities include, but are not limited to:

  • Reviewing each disability determination selected for QR in accordance with the QR standard described in GN 04440.007A. See also The Quality Review Process GN 04440.002B.

  • Reviewing and initiating corrective action on both disability determinations in a concurrent case, even though review data is only recorded for the sample case determination.

  • Reviewing and correcting all notices, as needed.

  • Rendering the final probability of reversal determination, subject to discretionary review by review component management.

  • Reviewing medical staff analyses and, if necessary, requesting medical guidance on medical issues (e.g., sufficiency of medical evidence). See Medical Review Process GN 04440.135A.

  • Ensuring the accuracy of all QR forms and review results recorded to the Office of Quality Review’s legacy system.

  • Initiating or taking corrective action on all deficiencies. See The Quality Review Process GN 04440.002B and Quality Review Standard GN 04440.007B.

  • Adjudicating cases when SSA takes jurisdiction and completing all related actions. See Assuming Jurisdiction – Policy Requirements GN 04440.244.

To Link to this section - Use this URL:
GN 04440.006 - Quality Reviewer Responsibilities - 01/09/2017
Batch run: 01/09/2017