TN 8 (06-04)
GN 04440.217 Corrections to SSA-831-C3/U3
For group II ending date decisional deficiencies and onset date deficiencies follow the procedure in GN 04440.217B. for changes to the SSA-831-C3/U3.
B. Procedure-review component
1. Correcting the SSA-831-C3/U3
Correct the appropriate blocks on the SSA-831-C3/U3 as follows:
a. Block No. 15 and 28
Enter the correct onset or ending dates.
b. Block No. 34
c. Block No. 37 and 38
Ensure that both the quality reviewer and the review medical contractor/psychological contractor (MC/PC) sign and date the corrected SSA-831-C3/U3. See below for exceptions.
Use block 34 if more space is needed.
EXCEPTIONS: The review MC/PC does not have to sign the SSA-831-C3/U3 if:
the onset or ending date change is due to SGA; or
the conditions listed in GN 04440.244E.2. are met; i.e., the physician statement and signature are on an appropriate medical evaluation document in lieu of a MC/PC signature on the SSA-831-C3/U3. See GN 04440.135B.3. and DI 24501.002C.1.
2. Correcting the rationale
Correct SSA-4268-C4/U4 if a rationale is involved, as follows:
make corrections where necessary; or
prepare a new brief rationale, explaining which aspects of the adjudicating component's determination are adopted (i.e., facts, findings and conclusions), if any, and which aspects of the determination are changed;
referral to the SSA-1774-U5 is permitted in lieu of re-recitation of facts, if preparing a new rationale.