TN 113 (07-20)

GN 04440.205 Quality Review Subsequent Returns

A. Introduction to subsequent returns

A subsequent return occurs when a review component returns a claim to an adjudicating component for additional development and/or correction, and the adjudicating component either:

  • does not complete all of the requested actions before routing the claim back to the review component, or

  • new, potentially material, issues arise because of the actions taken by the adjudicating component.

NOTE: The review component must not cite additional deficiencies on subsequent returns.

B. Correcting subsequent returns

When an adjudicating component does not complete all of the corrective actions delineated on the SSA-1774-U5 (Request for Corrective Action), or when subsequent case development raises material issues, the review component will either correct the case, or return the case to the adjudicating component for correction.

1. Case corrected in the review component

When the adjudicating component fully documents a case in response to a return, but the final determination, onset date, or ending date is incorrect, the review component will:

a. annotate all of the adjudicating component’s original determination and medical assessment forms, as well as notices, in the certified electronic folder (CEF) as “Do Not Process” or “Do Not Release”, as applicable,

b. code the subsequent return in the case processing system,

c. notify the adjudicating component, via an SSA-847-U3 (Request for Case Action), to explain the additional actions taken on the case, and why further corrections were needed,

d. either correct the onset or ending date or assume jurisdiction to correct the final determination,

e. prepare and release any necessary personalized notices, and

f. route the case to the field office.

NOTE: Do not assume jurisdiction for cases when the next level of appeal is a disability hearing at reconsideration. This includes:

  • continuing disability review medical cessations,

  • adverse reopenings of favorable initial determinations based on medical factors,

  • adverse reopenings of reconsideration reversals based on medical factors, and

  • adverse reopenings of cessations that change only the basis for the cessation.

These cases must always be returned to the adjudicating component for correction.

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.

EXCEPTION: If the case has another deficiency or technical corrective action requiring corrective action by the adjudicating component, or changing the ending date results in an adverse reopening of either an initial or a reconsideration case, the review component will follow the instructions in GN 04440.204B.1.

2. Case returned to the adjudicating component for corrective action

When the adjudicating component’s documentation is still insufficient to make the final determination or to determine the correct onset or ending date, the review component will:

a. code the subsequent return in the case processing system,

b. notify the adjudicating component, via a new SSA-1774-U5, Request For Corrective Action, to acknowledge the corrective actions already completed, explain why the case is still not policy compliant, and specify what additional actions are needed,

c. annotate the heading of the new SSA-1774-U5, “Second Return – No Additional Deficiency Cited”,

d. route the case to the adjudicating component for correction as a controlled return, and

e. follow-up with the adjudicating component in 60 days if the corrected determination has not been returned to the review component.


To Link to this section - Use this URL:
http://policy.ssa.gov/poms.nsf/lnx/0204440205
GN 04440.205 - Quality Review Subsequent Returns - 06/01/2004
Batch run: 07/21/2020
Rev:06/01/2004