TN 14 (12-10)

GN 04440.510 Completing the SSA-5524-U3, Request for Assistance

A. Background on using the SSA-5524-U3

Use the SSA-5524-U3 to request development from the field office (FO). For an exhibit of the SSA-5524-U3 see GN 04440.915.

B. Procedure for completing the SSA-5524-U3

1. Completing the fields on the SSA-5524-U3

Complete the appropriate information throughout the SSA-5524-U3. For the FO to address the deficiency properly, all information must be accurate and complete.

2. Completing the SSA-5524-U3 continuation page(s)

Prepare a continuation page(s) for additional space to:

  • fully explain the deficiency being cited; or

  • clarify to the FO what assistance is being requested.

At times, the review component must “work around” the space limitation (displayed in the “current field” attributes in each of the narrative fields) by selecting and moving some of the text to a continuation page.

To access a continuation page, you must create a new form using the SSA-5524-U3.

To access additional continuation pages of the SSA-5524-U3, you must create additional SSA-5524-U3 forms in eForms.

C. Disposition of the SSA-5524-U3

  • Make copies of the completed original SSA-5524-U3 for paper cases. Place one copy in the paper folder and mail additional copies to the adjudicating component and the center for disability (CD), when applicable. For further explanation on distribution of the SSA-5524-U3, refer to GN 04440.501B.6.
    NOTE: Please mail copies of the SSA-5524-U3, and the SSA-1774-U5 (Request for Corrective Action), to both the adjudicating component and CD.

  • For certified electronic folders (CEF), the same disability components that currently receive copies of the SSA-5524-U3 should also be able to view the SSA-5524-U3 in the CEF. Upload the SSA-5524-U3 by selecting the [send to EF] block at the Office of Quality Performance’s legacy system clearance. The FO receive an assistance request on the Electronic Disability Collect System Actions Page and is able to view the SSA-5524-U3 in the CEF. For further explanation on distribution of the SSA-5524-U3, refer to GN 04440.501B.7.

  • For a prior paper modular disability folder (MDF) and a current CEF, return both the prior paper MDF and the CEF to the adjudicating component for corrective action, when necessary.


To Link to this section - Use this URL:
http://policy.ssa.gov/poms.nsf/lnx/0204440510
GN 04440.510 - Completing the SSA-5524-U3, Request for Assistance - 01/09/2014
Batch run: 01/09/2014
Rev:01/09/2014