For a group I decisional deficiency involving clear evidence the claimant is engaging
in SGA, the review component will:
a. annotate all of the adjudicating component’s original determination and medical
assessment forms, as well as notices, in the CEF, as “Do Not Process” or “Do Not Release”,
b. code the deficiency in the case processing system,
c. notify the FO, via an SSA-5524-U3, Request for Assistance, to explain there is
clear evidence of SGA and an SGA denial is appropriate,
d. notify the adjudicating component, via an SSA-1774-U5, Request For Corrective Action,
to explain why the determination is not policy compliant and that the case will be
routed to the FO for an SGA denial, and
e. route the case to the FO.
NOTE: All of the adjudicating component’s original determination and medical assessment
forms, as well as notices, must remain in the CEF as part of the audit trail.