TN 8 (06-04)
GN 04440.204 Correcting Group I Deficiencies - General
A. Policy — Corrective Action
Group I deficiencies are returned to the adjudicating component for correction with some exceptions; i.e.,:
decisional deficiencies involving clear evidence that the claimant is engaging in SGA, and
procedural documentation deficiencies involving work activity issues only.
These deficiencies are sent to the FO for resolution of the issue. Refer to GN 04440.205 through GN 04440.211 for group I deficiencies that are sent to the FO for resolution. Non-recorded procedural documentation deficiencies in which the date last insured (DLI) for a Title II disabled worker claimant, the prescribed period for a disabled widow/er claimant or age 22 for a childhood disability claimant must be documented or verified are also sent to the FO for development. See GN 04440.235C.1.b.
In addition, concurrent Title II/Title XVI initial and reconsideration cases with a group I medical or procedural documentation deficiency involving onset may be corrected post-effectuation; i.e., payment can be effectuated on the Title XVI claim while the development is being undertaken for the Title II claim. See GN 04440.207.
B. Procedure — Review Component
1. Group I Deficiency Cases-Corrected By Adjudicating Component
For those group I deficiency cases that are corrected by the adjudicating component, the quality reviewer will:
NOTE: The original PRTF and/or RFC should remain in file as part of the audit trail. The original should be annotated “Do Not Process”.
2. Group I Deficiency Cases-Corrected By FO
For those group I deficiency cases that are corrected by the FO, the quality reviewer will:
Prepare an SSA-5524-U3 and return the deficient case folder to the FO.
Ask the FO to notify you if they have jurisdiction of the case and they prepare a determination form so the DICARS results screen can be completed. The FO can notify you either by mailing or faxing a copy of the determination form or by phoning or e-mailing the information, if preferred.
See GN 04440.950, GN 04440.945, DI 30005.121 and DI 30005.123 for an explanation of the group I decisional and documentation deficiencies and the corresponding DICARS deficiency code.