TN 30 (03-12)

DI 11005.001 Field Office Disability Interviews

Interviewers should review all relevant queries before conducting the interview, e.g., the Master Beneficiary Record (MBR), Supplemental Security Income Display (SSID), Disability Determination Services Query (DDSQ), CPMS (Case Processing and Management System), or ARPS (Appeals Review Processing System).

References:

GN 00203.001 Interviewing

GN 00203.002 Pre-Application Actions for Interviewing Claimants

SI 00601.060 Supplemental Security Income (SSI) Interviewing

A. Pre-claim interview

The purpose of a pre-claim interview before the actual disability interview is to determine:

  • The types of benefits the claimant may qualify for;

  • Whether there are any prior filings;

  • Whether there are any eligible dependents to develop for auxiliary (e.g., spouse or child) benefits;

  • The need for an interpreter; and

  • The applications, forms, and evidence needed for the interview.

During the preclaim interview, explain to the claimant:

  • Eligibility requirements and whether he or she appears to meet these requirements; and

  • Field Office (FO) and Disability Determination Services (DDS) roles in the disability claims process.

If the claimant does not appear to meet the eligibility requirements:

  • Explain why he or she is ineligible;

  • Issue an informal denial letter; or

  • Advise the claimant of his or her right to a formal determination if he or she insists on filing.

NOTE: Effective July 28, 2011, we will not accept a new disability application if the claimant has a prior disability claim for the same title and benefit type pending at any level of administrative review, unless the claimant meets the exception to this procedural change. For more information about Subsequent Disability Applications, see DI 51501.000.

1. Interviewing methods

The FO conducts disability interviews by several methods. If the claimant appears to meet the eligibility requirements, determine the best method of conducting the interview, i.e., face-to-face, self-help (e.g., Internet), telephone, or a combination of these methods. For details about the self-help and non-self-help methods, see DI 11005.018B.

2. Determine the best method for conducting the interview

If a claimant calls the FO or comes into the office and wants to file an application for disability benefits, ask the claimant questions to help you decide what the best method for conducting the interview, such as:

  • Alleged disabling conditions;

  • Ability to understand, read, and write English (For instructions on Special Interviewing Situations: Limited English Proficiency (LEP) or Language Assistance Required, see GN 00203.011);

  • Deaf or hard-of-hearing (For instructions on Special Interviewing Situations (Deaf or Hard-of-Hearing Individual, see GN 00203.012);

  • Blind or visually-impaired;

  • Willingness to complete the required forms; and

  • Computer and Internet access (self-help).

NOTE: The self-help method may not be appropriate if you determine that FO or DDS recontact will be difficult (e.g., when the claimant is homeless, will be difficult to contact by telephone, or will be on an extended trip and unavailable for contact). Instead, in these situations, complete all required forms during the initial interview and do not curtail completion of the SSA-3368 (Disability Report – Adult) or SSA-3820 (Disability Report – Child), and annotate the SSA-3367 (Disability Report – Field Office) with the reason for any current or expected difficulty in recontacting the claimant.

References:

GN 00203.003 Face-to-Face Contact with Claimants

GN 00203.015 Considerations in Telephone Interviewing

GN 00301.180 Identifying Claimants Who Need Assistance

GN 00203.009 Difficult Interviewing Situations

DI 11005.020 Curtailing Completion of the SSA-3368 (Disability Report – Adult) or the SSA-3820 (Disability Report – Child) Forms

GN 03910.001 Representation of Claimants – Overview

SI 00601.027 Title II Application as a Supplemental Security Income (SSI) Oral Inquiry

SI 00601.035 Adjudicating Title II When a Title XVI Application Is Filed

B. Disability interview

The goal of a disability interview is to produce a complete and accurate report of the alleged disabling conditions and develop for the earliest potential onset date (POD) based on non-medical factors. Therefore, give the claimant the opportunity to describe in his or her own words:

  • The alleged disabling conditions;

  • How the conditions prevent or limit work activity; and

  • In a title XVI child claim, how the disabling conditions limit the child’s ability to function.

When it is not possible to conduct a preclaim interview, e.g., claimant files and Internet claim (iClaim), determine the best method of conducting the interview at the beginning of the disability interview. (See details in DI 11005.001A.2. in this section).

1. Taking the disability claim

During the interview:

  • Complete the appropriate applications and related forms with the claimant, and obtain and explain the purpose of the SSA-827 Authorization to Disclose Information to the Social Security Administration.

  • Explain the roles of the FO and DDS in the disability claims process.

  • Help the claimant obtain supporting evidence, e.g., wages from an employer if work activity or insured status is an issue; and

  • Tell the claimant about his or her responsibility to report any change in work activity.

  • If you determine that the claimant does not meet certain factors of technical entitlement, e.g., insured status, curtail further development and deny the claim. (Refer to local procedures for taking abbreviated applications).

References:

GN 00203.004 Taking the Claim

DI 11005.055 Completing the Authorization to Disclose Information to the Social Security Administration (SSA) Form SSA-827

DI 11010.025 Guidelines for Deferral of Non-Medical Development

2. Identify potential claims issues

Identify and resolve potential claims issues. For example:

  • Substantial gainful activity (SGA);

  • Potential onset date (POD);

  • Prior claims activity;

  • Workers compensation or public disability benefits (WC/PDB) issues;

  • Claims requiring simultaneous development; and

  • Capability (if it appears the claimant may not be able to manage his or her benefits, request capability development by DDS or develop for a representative payee, as appropriate).

References:

DI 10501.025 Responsibilities and Procedures – Work Issue Cases

DI 11005.045 Completing the Paper Form SSA-3367–F5 (Disability Report–Field Office)

DI 11005.085 Prior Claims Activity

DI 11010.025 Guidelines for Deferral of Non-Medical Development

GN 00502.000 Determining the Need for, Developing and Selecting a Representative Payee – Table of Contents

3. Claimant rights and responsibilities

Advise the claimant of all rights and responsibilities (e.g., reporting work activity, changes in contact information, or medical improvement). Explain to the claimant:

  • The importance of identifying all medical sources to assist the DDS in processing the case;

  • Full cooperation if special examination is necessary. When a claimant asks about a possible special examination, provide the leaflet, “A Special Examination Is Needed for Your Disability Claim” (SSA Publication No. 05-10087);

  • SSA’s policy on payment for medical records;

  • His or her responsibility to report any change in work activity;

    NOTE: The claimant must report when work stops or starts, hours worked, or earnings.

  • Explain the Ticket To Work program and other work incentives, such as, the trial work period (TWP); and

  • Disability benefit payments may not be permanent, and we may review his or her work activity or impairments.

Finally, ask the claimant if he or she fully understands his or her rights and responsibilities.

References:

DI 11010.545 Payment for Medical Evidence of Record (MER)

DI 10005.001 Field Office (FO) Role – The Disability Process

GN 00203.005 Reporting Instructions – Title II Claims

SI 00601.060 Supplemental Security Income (SSI) Interviewing

DI 13010.001 Work Activity and Work Incentives

C. Terminating the disability interview

The FO is responsible for reviewing all interview forms for completeness and accuracy before sending the claim to the DDS. Ask the claimant to provide any required forms or evidence as quickly as possible if we cannot obtain certain information at the initial interview. Before terminating the interview:

  • Obtain a valid, acceptable signature;

  • Resolve discrepancies between the applicant’s statements and other information in the case file; and

  • Provide necessary information or guidance to the claimant.

Reference:

GN 00205.115 Retirement, Survivor, Disability Insurance (RSDI) Applications - Signature

Post-interview information

If the claimant calls the FO to provide additional information, record the information on the:

  • Report of Contact (RPOC) screen in the Modernized Claims System (MCS) or

  • Report of Contact (DROC) screen in the Modernized Supplemental Security Income System (MSSICS).

If the claimant provides information that will affect the medical development, enter the information via the Update-After-Transfer (UAT) utility and send a message to DDS to alert them to the new information.


To Link to this section - Use this URL:
http://policy.ssa.gov/poms.nsf/lnx/0411005001
DI 11005.001 - Field Office Disability Interviews - 07/10/2014
Batch run: 07/10/2014
Rev:07/10/2014