TN 21 (02-14)

GN 04440.202 Controlling Deficient Disability Cases

A. Policy on controlling deficient cases

The review component maintains accurate records of the final disposition of deficiency cases returned to the adjudicating component or the field office (FO). Control of deficient cases is to ensure:

  • correction of the deficiency;

  • timely return of the corrected case or the deficiency transmittal form and corrected disability determination; and

  • input of results data.

B. Review component procedures for controlling deficient cases

1. Deficiency return diary

Use the following timeframes to control when the adjudicating component or field office returns the corrected case:

  • Group I and group II documentation deficiencies sent to the adjudicating component for correction – 60 calendar days.

  • Group I decisional deficiencies and all other deficiencies sent to the adjudicating component for correction – 30 calendar days.

  • Group I and group II deficiencies sent to the FO for correction – 14 calendar days. NOTE: The 14 calendar days are only a reminder to follow-up with the FO. The majority of the cases, specifically instances where we need additional documentation, will take longer than 14 days.

2. Follow-up instructions

Follow-up if you do not receive the corrected or rebutted case by the controlled due date, as follows:

  1. Query the case control system.

  2. Request the folder if the case is not in the adjudicating component.

  3. Call or prepare a letter, fax or email to the adjudicating component requesting a status report if the case is still in the adjudicating component. Include the following:

    • Social Security Number under which the claim is filed;

    • name of claimant or beneficiary;

    • title, type of claim and type of review;

    • date the case was sent to the adjudicating component for correction; and

    • date the corrected case was due.

  4. Continue to follow-up until the case is:

    • received;

    • corrective action is verified; and

    • data input is complete.

3. Non-Return of folder to the review component

You will not receive some cases back after corrective action (i.e., cases sent to the FO for a technical denial, or CDR reconsideration affirmation cases sent to the disability hearings unit (DHU) for a determination). Do not clear the diary control until you receive notification of the final disposition of the case (e.g., the FO telephones the results or sends a copy of the amended disability determination). If you are experiencing difficulty in obtaining copies of the determination, you may query the system for the final determination and code the results data based on the query.


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http://policy.ssa.gov/poms.nsf/lnx/0204440202