TN 11 (04-16)
GN 04461.010 Supplemental Security Income (SSI) Quality Reviews
A. Introduction to SSI quality reviews
The Office of Quality Review (OQR) monitors the quality of the Supplemental Security Income Program (SSI) program. OQR reviews measure payment accuracy and compliance with national and regional instructions.
OQR uses the results from ongoing SSI reviews and special studies to:
establish accuracy information;
report to Congress on the financial health of the SSI program;
identify program policy and system areas for corrective action; and
assist other components in formulating operating policy.
There are two ongoing SSI reviews:
The Stewardship Review is a payment review. Cases are selected by Housed Under Number based on a payment made in the sample period.
The Transaction Accuracy Review (TAR) is a Program Operation Manual System (POMS) compliance review of selected initial claim, redetermination (RZ) and limited issue (LI) transactions. The review measures POMS compliance by evaluating the accuracy of Field Office (FO) adjudicative decisions.
NOTE: Special studies provide management with specific data in areas of particular concern.
B. Process for SSI quality reviews
1. SSI quality review
OQR selects a random sample of cases each month.
Quality reviewers in OQR field sites throughout the country conduct reviews on the selected cases.
The quality review consists of one or more of the following actions by OQR:
A review of the SSI claim or RZ or LI folder and other documents and records related to the SSI case;
A contact (mail or telephone) with the SSI recipient or representative payee; and
Contacts with third-party collateral sources of information.
OQR prepares reports for publication and develops corrective action recommendations based on the review data. Recommendations may take the form of changes to the law, regulations, or policy and procedures.
2. Quality Review (QR) and contact with the public
OQR field sites contact members of the public to complete their reviews.
For Stewardship Reviews, the OQR reviewer sends the SSI recipient or representative payee an appointment letter to schedule a telephone interview and explain the purpose of the review. The appointment letter or request notice provides the quality reviewer's name and a telephone number in the OQR field site that the SSI recipient or representative payee can call with questions regarding the SSI QR.
For TAR, the reviewer may send a request notice to the recipient or representative payee if he or she needs further development for an issue.
The SSI recipient or representative payee may contact the FO or TeleService Center (TSC) to verify the authenticity of the SSI QR or identity of the OQR employee. In such cases, the FO should provide the individual with further assistance or information regarding the QR. See TC 00101.035 for TSC instructions. See the following link for a list of OQR personnel: OQR Field Reviewers.
3. OQR field site contact information
You can find contact information for OQR field sites at this link: OQR Field Sites.