When the claimant does not comply within 10 calendar days from the date of your initial,
written request for evidence (e.g., submitting a completed form) or action (e.g.,
calling a doctor to request they fax a medical record), follow up once by telephone
or letter. Give the claimant 10 additional calendar days from the date of your follow-up
to comply with your initial, written request, unless the claimant provides a good
reason for you to give more time.
For determining with whom to follow up, see DI 23007.005
For the definition of good reason, see DI 23007.001B.
For claimants who require special handling, see DI 23007.001A,
For how to make reasonable effort to identify and involve a third party, see DI 23007.010.
NOTE 1: When the claimant requires special handling and does not comply with your initial,
written request for evidence or action in the additional time that you have given,
you must also make a reasonable effort to identify and involve a third party.
NOTE 2: When there is FO documentation in the file that the claimant refused to identify
a third party, do not attempt to identify a third party, see DI 11005.022B.
NOTE 3: When you have already stopped attempts to get the claimant to attend a consultative
examination (CE) appointment in accordance with DI 22510.019, do not attempt to obtain the claimant’s cooperation in providing additional evidence
or taking additional action. Make a determination using the sequential evaluation
process, see DI 23007.015.
1. Follow up by telephone
When you follow up by telephone, you may either:
NOTE: When you do not speak to the claimant, applicant, appointed representative, or third
party, and you cannot leave a message, follow up once by letter, see DI 22505.014A.2.
a. You speak to the claimant, applicant, appointed representative, or third party
Do the following during the conversation:
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•
Provide your contact information and explain the purpose of the call.
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•
Explain that the claimant must comply with your initial, written request for evidence
or action. State that if the claimant does not comply with your initial, written request
for evidence or action in the additional time that you have provided, you may make
a determination based on the evidence in file, which means you may find the claimant
is not disabled.
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•
When you need evidence, attempt to obtain it over the telephone. When you cannot obtain
the evidence over the telephone, give the claimant 10 additional calendar days from
the date of your telephone call to comply with your initial, written request for evidence,
unless there is a good reason to give more time.
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•
When you need action, give the claimant 10 additional calendar days from the date
of your telephone call to comply with your initial, written request for action, unless
there is a good reason to give more time, and
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•
State that if the claimant does not comply with your initial, written request for
evidence or action in the additional time that you have provided, you may make a determination
based on the evidence in file, which means you may find the claimant is not disabled.
Document the date, content of your conversation, and to whom you spoke, on an SSA-5002 Report of Contact, the claims communication section in eCAT, or the DDS worksheet.
For the definition of good reason, see DI 23007.001B.
You may leave a message on the voicemail recording system of a telephone number in
the claim file that is attributable to the claimant, applicant, appointed representative,
or third party. You may also leave a message with an adult who answers a telephone
number in the claim file that is attributable to the claimant, applicant, appointed
representative, or third party (e.g., the claimant’s spouse or an appointed representative’s
assistant).
Include all of the following in the message:
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•
Provide your contact information and date that you called. Do not disclose any unnecessary
personal information about the claimant,
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•
Explain that the claimant must comply with your initial, written request for evidence
or action. Identify the evidence or action that you initially requested in writing
and give the claimant 10 additional calendar days from the date of your message to
comply, and
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•
State that if the claimant does not comply with your initial, written request for
evidence or action in the additional time that you have provided, you may make a determination
based on the evidence in file, which means you may find the claimant is not disabled.
Document the date, and content of your message, and with whom you left it, on an SSA-5002 Report of Contact, the claims communication section in eCAT, or the DDS worksheet.
Include all of the following in the letter:
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•
Your contact information, date of your letter, and the method by which the claimant
should provide any requested evidence (e.g. telephone, fax, mail),
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•
An explanation that the claimant must comply with your initial, written request for
evidence or action. Identify the evidence or action that you initially requested in
writing and give the claimant 10 additional calendar days from the date of your letter
to comply, and,
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•
A statement that if the claimant does not comply with your initial, written request
for evidence or action in the additional time that you have provided, you may make
a determination based on the evidence in file, which means you may find the claimant
is not disabled.