TN 1 (04-89)

GN 04442.705 First Level Rebuttal - Initial, Reconsideration, and Continuing Disability Review Claims

A. Introduction

This section describes the first level rebuttal actions the DRS takes when it disagrees with a deficiency and DQB actions when it rescinds or affirms the deficiency.

B. Description of DRS Action - General

1. PREPARES MEMORANDUM

DRS prepares a memorandum to the DQB chief that explains the DRS position on the deficiency and addresses each area of disagreement.

2. RELEASES MEMORANDUM

DRS sendsthe memorandum and folder to the DQB.

C. Procedure - General

1. AGREEMENT

  1. Rescind the deficiency.

  2. Prepare a results form.

  3. Return the claim to the DRS to effectuate the determination.

2. DISAGREEMENT

  1. Arrange an informal meetingbetween the DQB and DRS directors, or their designees.

  2. Include a regional medical consultant if a medical issue is involved and /or a vocational specialist if a vocational issue is involved.

  3. Prepare a meeting summaryand place it in the folder.

  4. Take the consensus actionto rescind or affirm the deficiency. (The DRS will take the consensus action.)

  5. If consensus cannot be reached, prepare a memorandum to the DRS director explaining the DQB position.

  6. If the DRS still disagrees,it will immediately pursue a second level rebuttal.

D. Operating Policy - Referral of Policy Issues

If at any time during the first level rebuttal the issue being resolved requires policy clarification, the claim must be immediately referred to OD for a policy ruling.

E. Description of DRS Action - Policy Issue

1. PREPARES MEMORANDUM

DRS prepares a memorandum that clearly explains the policy issue.

2. RELEASES MEMORANDUM

DRS sends the memorandum and folder to the DQB.

F. Procedure - Policy Issue

1. COORDINATION WITH OD

  1. Send the folder to OD through the Disability Programs Branch.

  2. Monitor to insure that a fast response is received.

2. ACTION TAKEN

  1. When the policy issue is resolved, take action on the deficiency that is consistent with the OD policy ruling.

  2. Send the folder and OD policy ruling to the DRS to take final actionon the claim.


To Link to this section - Use this URL:
http://policy.ssa.gov/poms.nsf/lnx/0204442705
GN 04442.705 - First Level Rebuttal - Initial, Reconsideration, and Continuing Disability Review Claims - 07/29/1994
Batch run: 01/27/2009
Rev:07/29/1994