If an adjudicating component identifies FSF in a case, the adjudicator is required
to evaluate and disregard evidence as necessary, per DI 23025.025, when making the
determination.
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1.
If an investigation unit (IU) (i.e., the Office of the Inspector General (OIG) or
a Cooperative Disability Investigations Unit (CDIU)) completed an investigation, consider
the report of investigation (ROI), or any additional documentation received, in your
review. Evidence in the case file may be disregarded based on findings outlined in
the ROI. If there is an ROI, or any other investigative information, in file when
you receive the case for quality review, ensure that the adjudicating component weighed
the evidence carefully and followed directions per DI 23025.025B.
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2.
The adjudicating component is required, in most cases, to hold the case until the
investigation for FSF is complete. If you receive a claim with an open FSF investigation,
return it to the adjudicating component. There are two exceptions per DI 23025.020B.1.2.
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a.
If there is sufficient evidence in file to make a denial determination, the adjudicating
component can make the determination. The investigator stops his or her investigation
and provides any existing documentation. The adjudicator adds the available evidence
to the case file.
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b.
If the evidence in file supports an allowance determination based on impairments other
than those suspected for FSF, the adjudicating component can make the determination.
IMPORTANT NOTE: If an ROI or any other investigatory information is received during the quality review,
quality reviewers will treat that information as trailer mail (see DI 22520.000).