TN 11 (04-16)

GN 04461.040 Providing Assistance to the Office of Quality Review

A. Introduction to providing assistance to the Office of Quality Review

The Office of Quality Review (OQR) may need to request the field office’s (FOs) assistance in certain circumstances. They use the SSA-93 (Quality Review Feedback Report).

NOTE: For integrity purposes, FO management should assign the case to someone who has never been involved with the recipient or representative payee.

B. Procedure for unable to locate, refuses to cooperate, or is unable to respond

1. OQR unable to locate recipient

When OQR requests assistance, the FO should attempt to locate the recipient.

Respond to the OQR SSA-93 via the SSA-93 website using the “Other” option indicating one of the following in the comments area:

  • FO contacted the recipient – include the current residence address, mailing address, and telephone number; and the recipient agreed to cooperate with OQR;

  • FO contacted the recipient – include the current residence address, mailing address, and telephone number; and the recipient refuses to cooperate with OQR; or

  • FO cannot locate the recipient, they suspended the recipient’s benefits, or they referred the case to the Office of the Inspector General.

2. Recipient or Representative payee refuses to cooperate with OQR

The FO interviews the recipient or representative payee and takes the following actions:

  • Determines the reason for refusal to cooperate, attempts to dispel any fears;

  • Obtains a promise of future cooperation. Inform the recipient or representative payee that OQR will re-contact him or her to complete the interview. Document the FO’s interview on a Report of Contact (RC);

  • Responds to the OQR SSA-93 using the “Other” option with an explanation of the actions taken in the comments area of the SSA-93 website, include the location of the RC, and the following;

  • Indicate whether the:

    1. recipient or representative payee refuses to cooperate with the FO,

    2. FO suspended benefits;

    3. FO appointed a new payee; or

    4. FO referred the case to OIG (For due process, see SI 02301.300); and

  • Refer to the electronic location of any relevant documentation.

3. Recipient is unable to respond to OQR requests

If OQR finds that the recipient cannot complete an interview or provide evidence, they will request FO assistance. Upon receiving a request for assistance, the FO should:

  • Contact the recipient and determine if payee development is necessary.

  • Use the “Other” option on the SSA-93 website to provide OQR with the name and telephone number of the person who will act on the recipient's behalf, or indicate that the recipient is now able to respond.

When finished, send an email reply to OQR through the website. A copy of the SSA-93 is available on the website via a link if needed. Refer to the SSA-93 User Guide for more information.


To Link to this section - Use this URL:
http://policy.ssa.gov/poms.nsf/lnx/0204461040
GN 04461.040 - Providing Assistance to the Office of Quality Review - 04/12/2016
Batch run: 04/12/2016
Rev:04/12/2016