TN 3 (10-09)

DI 12005.020 Processing a Reconsideration Determination Following the Disability Determination Services (DDS) Review

A. Processing guidelines

Develop and process favorable reversals and affirmations in the same manner as initial claims, including notice preparation, as well as folder retention and routing, if paper folders are involved. In addition, note the following for reversals:

  • Handle reversals on a priority basis.

  • For allowances of subsequent applications while an appeal of a prior claim is pending before the Appeals Council, follow DI 12045.027D.

B. Title II

Do not delay the number holder's award pending auxiliary development.

Clearly identify non-EDCS Title II reversals that are being routed to the program center (PC) by annotating “Recon Reversal” on the routing sheet.

C. Title XVI

Conduct a pre-effectuation review (PERC), when required, per

  • SI 00603.030- Pre-effectuation Review Contact (PERC) – Introduction; and

  • SI 00603.035 - Pre-effectuation Review Contact (PERC) for Deferred Claims.

Prepare non-MSSICS reversal letters using an SSA-L8455-U2 (SSI Notice of Reconsideration) via DPS.

If the reconsideration reverses a prior medical denial but the claim is being denied for non-medical reasons, include stock paragraph 1407 in the notice (NL 00804.200 – Disability).

D. References

  • GN 03102.175 – Component Responsibility in the Reconsideration Process

  • NL 00802.050 – SSA-L8455-U2 and SSA-L8456-U2, SSI Notices of Reconsideration—Initial Claims

  • DI 11010.000 – Initial Claims Processing

  • DI 11010.370 – Field Offices (FO) Retaining and Shipping Paper Modular Disability Folders (MDF)

  • NL 00804.100 – Numerical Index of Automated and Manual Paragraphs


To Link to this section - Use this URL:
http://policy.ssa.gov/poms.nsf/lnx/0412005020
DI 12005.020 - Processing a Reconsideration Determination Following the Disability Determination Services (DDS) Review - 11/08/2013
Batch run: 11/08/2013
Rev:11/08/2013