TN 14 (12-10)

GN 04440.946 Definitions of Group II Deficiencies

For a complete explanation of group II deficiencies and the corresponding policy, refer to DI 30005.125 DI 30005.126.

A. Policy on group II decisional deficiencies

1. Group II onset date decisional deficiency with no reopening issue

Cite a group II onset date decisional deficiency when the case contains an incorrect onset date determination; i.e., the case contains sufficient documentation to support a different onset date than the adjudicating component's established onset date (EOD).

2. Group II onset date decisional deficiency with a reopening issue involved

Cite a group II onset date decisional deficiency involving a reopening issue when the case contains the prior folder from the last adjudicated unfavorable determination, there is sufficient evidence in file to establish the onset date, and the adjudicating component either:

  • failed to reopen the prior determination when they should have, or

  • reopened the prior determination and established the onset date within the previously adjudicated period when they should not have.

Included in this category is the situation when the adjudicating component either correctly reopens the prior determination but establishes an incorrect onset date, or incorrectly fails to reopen the prior determination, regardless of whether the adjudicating component establishes the correct onset date.

3. Group II ending date decisional deficiency

Cite a group II ending date decisional deficiency when the case contains sufficient documentation to support a different ending date. Included in this category are cases in which the adjudicating component prepared:

  • A closed period allowance, and the review component determined that the ending date is incorrect;

  • A closed period allowance that should have been an open period allowance; and

  • An open period allowance that should have been a closed period allowance.

4. Group II cessation date decisional deficiency

Cite a group II cessation date decisional deficiency when the case contains an incorrect cessation date determination; i.e., the case contains sufficient documentation to support a different cessation date.

B. Policy for group II documentation deficiencies

1. Group II onset date documentation deficiency

Cite a group II onset date documentation deficiency when the case contains insufficient documentation to support the adjudicating component's EOD or any other date. Included in this category is failure to consider a reopening issue when:

  • The alleged onset date or the adjudicating component's EOD falls within a period already adjudicated in the last unfavorable determination; and

  • The prior folder is not associated with the current file.

NOTE: Do not cite a group II onset date documentation deficiency when the field office did not inform the adjudicating component of a prior determination and there was no indication of a prior determination in the case file.

2. Group II ending date documentation deficiency

Cite a group II ending date documentation deficiency when an allowance case contains insufficient documentation to determine whether an open or a closed period of disability should have been established. It can also apply when it is clear a closed period of disability exists, but the evidence is insufficient to determine the correct ending date.

3. Group II cessation date documentation deficiency

Cite a group II cessation date documentation deficiency when the case contains insufficient documentation to support the cessation date.

4. Group II work activity documentation deficiency

Cite a group II work activity documentation deficiency when there is an unresolved work activity issue that has the potential to affect the onset date, ending date, or cessation date when resolved.


To Link to this section - Use this URL:
http://policy.ssa.gov/poms.nsf/lnx/0204440946
GN 04440