TN 11 (01-17)
DI 13005.110 Field Office (FO) Procedures for Processing Disability Determination Services (DDS) and Disability Processing Branch (DPB) Referrals of Medical Improvement Not Expected (MINE) or MINE-Equivalent Cases
A. Processing a DDS or DPB referral of a CDR
If the DDS or DPB is unable to complete the initial telephone contact, the DDS or DPB will automatically send a review notice. If the DDS or DPB are unable to complete the telephone contact following the review notice, the DDS or DPB will request FO assistance.
In requesting FO assistance, the DDS examiner will forward the case folder with the form SSA-883-U3 (Request For Evidence Of Assist Disability) or an electronic assistance request (AR). The DDS will indicate on the SSA-883-U3 or the AR, the telephone number used in trying to contact the disabled individual or representative payee. The SSA-883-U3 or AR will identify exactly what information it needs the FO to obtain. The DDS or DPB will attach the form SSA-454-BK (Continuing Disability Review Report) with the items annotating what should be completed and the nature of the impairment, see DI 13005.200. Knowledge of the impairment will enable the FO interviewer to tailor the questions on the SSA-454-BK (Continuing Disability Review Report) to fit each individual situation.
The FO must make all efforts to contact the disabled individual or representative payee. The FO should attempt to contact the disabled individual, the representative payee or a third party by telephone. The FO must use city directories and any other local means available to locate the disabled individual or representative payee. If you cannot locate the disabled individual or representative payee and the whereabouts are unknown, see DI 13015.025B.
NOTE: For electronic FO case procedures, see DI 81010.000.
B. Procedure for the FO contacting the disabled individual and representative payee
The FO must process all of the information shown on the SSA-883-U3 or AR and the SSA-454-BK (Continuing Disability Review Report), as well as any signed statements from the DDS request. Advise the disabled individual and representative payee that a DDS examiner may re-contact him or her in the future for further information. Once you make contact, be extremely sensitive to the nature of the impairment. Also, advise the individual that we will notify him or her in writing of the medical determination.
NOTE: If the disabled individual, representative payee or third party alleges work activity following the normal development procedures in DI 13010.025. Alert the DDS of any allegations of medical improvement (MI) made by the disabled individual, representative payee or the third party.
When you obtain the requested information, return the folder, the SSA-883-U3 or AR, all statements and the FO comments to the DDS. The DDS will contact the medical source to verify the disabled individual or representative payee's statement.
C. Policy on the FO’s observation of the disabled individual
In some cases, the DDS is unable to secure the name of any medical source or non-medical third party to verify the disabled individual or representative payee’s statement. A regular CDR will be necessary if, the lack of a medical source raises an issue of possible medical improvement (MI) except in cases that have almost no likelihood of MI. In these cases, the DDS will request FO personal contact to furnish observations of the individual’s condition(s).
The FO will receive a request only when there is virtually no question of continuing impairment severity and the FO must make the contact as easy as possible for the disabled individual. The FO should attempt contact via telephone unless the disabled individual indicates he or she can easily come in to the FO. These cases are highly sensitive and the FO must carefully avoid creating unnecessary anxiety for the disabled individual. In such case, the FO must be alert to the possibility of making a referral to social services, since these disabled individual is not in contact with any assisting agencies.