TN 55 (08-96)
DI 12586.020 FO Actions Prior to DDS Readjudication -- Stieberger
A key to processing Stieberger reopenings is understanding the concept of the DEVELOPMENT/PAYMENT periods. The FO must compute the DEVELOPMENT PERIOD and PAYMENT PERIOD(s) prior to sending a case to the DDS.
The settlement agreement permits the DDS, subject to certain exceptions and exclusions explained below, to develop for a limited period, usually starting with the 48th month prior to SSA's receipt of the request for review. (See DI 12586.035 for instructions on computing the Stieberger DEVELOPMENT PERIOD, including in situations where the class member is deceased.)
The Stieberger PAYMENT PERIOD is also limited (i.e., benefits for the period prior to 12/1/91 will never exceed 48 months and may be less than 48), although it usually begins earlier than the DEVELOPMENT PERIOD. (See DI 12586.045 (title II) and DI 12586.050 (title XVI) for instructions on computing the PAYMENT PERIOD).
2. Concurrent Cases
Because the factors affecting the computation of the PAYMENT PERIOD for title II and title XVI are different, a concurrent case may have different PAYMENT PERIODs under each title. One DEVELOPMENT/PAYMENT PERIOD worksheet (DI 12586.095, Exhibit 10) can be used in concurrent claims.
B. 3 Types of Cases FOs will Receive
FOs will receive three types of alert/query packages (see C., below) for reopening:
FO screening cases.
ODIO/OHA screen-ins on subsequent alerts, including FO jurisdiction and DDS jurisdiction cases (See DI 12586.025 D).
ODIO screen-ins on Title Unknown and subsequent allowance case alerts.
C. Description of Alert Package
The Stieberger alert package consists of a green jacket containing the:
Stieberger Court Case Flag/CATS alert;
Any medical or other evidence submitted with the Reply Form; and,
SSA 1696-U4, Appointment of Representative (if any).
The alert package also includes systems data regarding:
claims activity (e.g., FACT, SSR/STALE, OHAQ),
folder locations (e.g., AR-25, BDIQ, ODIO Overnight), and
earnings (SEQY or similar extract).
Prior folders will not be included, except if there has been a subsequent fully favorable allowance.
D. Procedure -- Screen-Ins
Use the procedure below in processing Stieberger screen-ins.
Compute the DEVELOPMENT PERIOD (see DI 12586.035) in order to know what period to cover in the SSA-3368-BK. Use the DEVELOPMENT/PAYMENT PERIOD worksheet in DI 12586.095, Exhibit 10, or the Stieberger PC software (if available), to compute the DDS DEVELOPMENT PERIOD.
If computation of the DEVELOPMENT PERIOD shows that the case may be an SGA denial, see DI 12586.040B.5. Otherwise, proceed to step 3., below.
Contact class member and/or any representative and, at that time, offer the opportunity to submit medical evidence covering from the beginning of Stieberger DEVELOPMENT PERIOD through the present. Accept any evidence submitted by the claimant, regardless of its date. (See DI 12586.003). If the class member has a current claim pending, explain that we may (unless she/he objects) consolidate the Stieberger review with the pending claim (See DI 12586.025B.)
Secure a disability interview report (SSA-3368-BK for initial denials, SSA-454-BK for cessations) and authorizations (SSA-827s). In completing the SSA-3368-BK cover the period from the start of the Stieberger DEVELOPMENT PERIOD through the present. In completing the SSA-454-BK, cover the period from the date of the comparison point decision (CPD) through the present. The comparison point decision is the last favorable decision that preceded the cessation. If the claimant is currently entitled to an unreduced benefit or a disability benefit, cover only up to the beginning date of that current entitlement.
Obtain the individual's responses to the questions on the Stieberger Supplement (i.e., the form created to complete the information needed to review Stieberger claims). (See DI 12586.095, Exhibit 2).
The medical questions in Part II of the Stieberger Supplement refer to the period (if any) from the AOD of the earliest Stieberger title II claim (or the date of the earliest Stieberger title XVI claim) through the month prior to the first month of the DEVELOPMENT PERIOD. If there is no earlier period, indicate this and proceed to Part