TN 1 (04-89)

GN 04442.210 Quality Review Sequence

A. Operating Policy

Railroad disability determinations are reviewed in the same sequence as State disability determinations. Since the RMCS will have already signed the determination in its capacity as a member of the adjudicative team, claims should be referred to RMCS only when special circumstances dictate.

B. Examples

Examples of special circumstances are:

  1. a. 

    Expert medical assistance is required to further evaluate the:

    • Adequacy of the medical evidence,

    • Correctness of an onset, ending, or cessation date,

    • Level of impairment severity, or

    • Level of residual functional capacity (RFC).

  2. b. 

    The determination involves a mental impairmentand the folder does not contain a properly completed SSA-2506-BK.

  3. c. 

    The determination should be based on a consideration of residual functional capacity and it does not contain an SSA-4734-F4 or the SSA-4734-F4 is not completed properly.

  4. d. 

    The review component believes the determination is medically deficient.

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GN 04442.210 - Quality Review Sequence - 12/22/1989
Batch run: 12/22/1989