Effective Dates: 08/16/2021 - Present Previous | Next

TN 10 (08-21)

RS 02803.145 Follow up Procedure

A. RSI CASES

1. General

This follow up procedure only applies when a case is manually referred to the PC.

2. Five Working Day Timeframe

The reply to a Critical Case Request that meets the critical case definition is due by the end of the 5th working day following the date the request was transmitted to the PC.

If a reply has not been received by the tickle date, secure a current online Master Beneficiary Record (MBR), Processing Center Action Control System (PCACS) or the Evidence Portal (EP) to determine the status of the request. Follow up with the PC to make sure the action is pending. If the action is not pending in the PC, send a follow up Modernized Development Worksheet (MDW).

3. Twenty Working Day Timeframe (Railroad Certification Cases Only)

The final reply for Railroad Retirement Board (RRB) certification cases where the FO received an interim reply advising that RRB was contacted is due 20 working days from the date the Critical Case Request was transmitted. If a final reply is not received by the due date, secure a current MBR and recontact the beneficiary. If the issue is not resolved, a member of the FO management staff should telephone or e-mail the PC per RS 02803.120.

(The 20-day timeframe has been established because SSA CANNOT, under any circumstances, certify payment to a beneficiary whose payment is or will be certified to RRB for payment. The PC staff calls RRB and requests priority handling and expedited payment. Upon completion of RRB action, RRB contacts the PC staff and advises of the action taken. A final reply is then furnished to the FO by the PC.)

4. Twenty Calendar Day Timeframe (Excluded Cases)

The reply to a critical case referral sent to the PC in which the FO received a reply advising that the inquiry does not meet the critical case definition is due 20 calendar days from the date on which the request was transmitted. The reply to an inquiry that does not meet the critical case definition is due 20 calendar days following the date the PC notified the FO that the PC staff has the request. If an interim reply is received, reschedule the final reply due date for another 20 days after the interim reply.

If neither an interim nor final reply is received by the due date, obtain a current MBR and/or PHUS query and re-contact the beneficiary. If the issue is not resolved, a member of the FO management staff should telephone or e-mail the Assistant Regional Commissioner, Management and Operations Support (ARC MOS) and ask the ARC MOS to follow up with the PC.

B. DIB CASES

1. Interim RIB Cases

Treat these cases the same as RSI cases (see RS 02803.145A.). Initiate follow ups with the RSI PC that has jurisdiction of the SSN or, if applicable, the Assistant Regional Commissioner, Management and Operations Support.

2. Initial Claims, Reconsiderations and Reinstatements Requiring Disability Determinations

a. File Transmitted to DDS Via Form SSA-1671-U2, File in DDS and Form SSA-1671-U2 Forwarded to DDS, or File Sent Directly to PC for Disability Decision

Since these cases involve a disability decision, the follow up period is 25 calendar days. If notification of a final action (i.e., Form SSA-831-U5) or a status report advising the reason for the delay of the decision is not received within 25 days after the request for priority handling was sent, recontact the claimant. If the claimant has not received notification of the decision, query the MBR and case control system to obtain the location and status of the claim. If still necessary, follow up by telephone with the DDS or, if the folder was sent to the PC, send a follow up Critical Case Request. Re-diary the case for 10 calendar days. Send a copy of the follow up to the appropriate ARC MOS. If notification is not received advising status or final action on the case within 10 days after the follow up, a member of the FO management staff should telephone or e-mail the ARC MOS for follow up with the DDS or the PC.

b. DDS Forwarded File Identified for Priority Handling

When the DDS notifies the FO of the transfer to the PC, re-establish the follow up due date using the date the notice was received in the FO, and that the request for priority handling was sent to the PC by the DDS. Treat these cases the same as RSI cases (see RS 02803.145A.). Include all factors of entitlement (e.g., DDS decision) in the follow up with the PC or, if applicable, the ARC MOS.

c. FO Forwarded File Identified for Priority Handling to PC or File in PC and Critical Case Request Sent — DDS Decision Complete

Treat these cases the same as RSI cases (see RS 02803.145A.). The follow up Critical Case Request must include all factors of entitlement (e.g., DDS decision) and whether or not payment was triggered by the FO. Initiate the followup with the PC or, if applicable, the ARC MOS.

3. Reinstatements, Delayed or Interrupted Payments - Nondisability Issues

Treat these cases the same as RSI cases (see RS 02803.145A.). Initiate the followup with the PC or, if applicable, the Assistant Regional Commissioner, Programs, Insurance Programs Branch.

To Link to this section - Use this URL:
http://policy.ssa.gov/poms.nsf/lnx/0302803145
RS 02803.145 - Follow up Procedure - 08/16/2021
Batch run: 08/16/2021
Rev:08/16/2021