TN 3 (02-20)

DI 23007.005 Contacting the Claimant, Applicant, Appointed Representative, or Third Party in Claims Involving Failure to Cooperate and Insufficient Evidence

A. Who to contact when the claim does not require special handling

You must contact (by telephone or letter) the:

  • Claimant when the claimant does not have an applicant filing on his or her behalf, or appointed representative.

  • Applicant when the claimant has an applicant, but not an appointed representative.

  • Appointed representative and claimant when the claimant has an appointed representative but not an applicant (for contact by letter). For contact by telephone, see GN 03910.050.

  • Appointed representative and applicant when the claimant has both (for contact by letter). For contact by telephone, see GN 03910.050.

NOTE 1: You are not required to involve a representative payee unless the representative payee is also the third party or applicant.

NOTE 2: An appointed representatives may ask you to communicate directly with the claimant or applicant for a specific issue. Comply with that request with one exception. When the claimant does not comply with your follow up request for evidence or action, or does not attend the consultative examination (CE) appointment, first make a reasonable effort to contact the appointed representative and give the representative 10 days to comply with your request. When the appointed representative requests more time, determine a reasonable amount of time. A reasonable effort to contact a representative is the same as a reasonable effort to involve a third party, see DI 23007.010. When the appointed representative does not contact you and assist with getting the claimant to submit the needed evidence or action, you may then stop attempts to get the claimant to comply with your request.

REMEMBER: An adult claim that has an applicant or appointed representative does not require special handling, even if the claimant falls into one of the special handling categories.

B. Who to contact when the claim requires special handling

You must contact (by telephone or letter) the claimant.

You may make a reasonable effort to involve a third party at any point in the process, but you may not discontinue attempts to develop evidence requiring the claimant's cooperation until you make a reasonable effort to identify and involve a third party, see DI 23007.010.

When the claimant does not comply with your follow-up request for evidence or action, or does not attend the CE appointment, make a reasonable effort to identify a third party when the Field Office (FO) has not identified a third party or has not documented that the claimant refused to identify a third party. When you identify a third party, contact him or her and attempt to get him or her to cooperate with your request. When you are not able to identify a third party, or if you identify but are unable to involve the third party, stop attempts to get the claimant to comply with your request or attend the CE appointment. When the FO has identified an additional third party in Section 11 of the SSA-3368 Disability Report - Adult, SSA-3441 Disability Report - Appeal, or the SSA-454 Continuing Disability Review Report, you must make a reasonable effort to involve the additional third party when the attempt with the other third party was not productive. When the FO indicates the claimant refused to identify a third party, do not attempt to identify a third party.

For steps to confirm a CE with special handling, see DI 22510.019D.

For claimants who require special handling, see DI 23007.001A.

For how to make a reasonable effort to identify and involve a third party, see DI 23007.010

NOTE: You must make a reasonable effort to involve the third party from the current level of review. Do not use a third party from a prior folder or prior appeal level.

C. How to document your contact

1. When you speak to someone

When you speak to the claimant, applicant filing on his or her behalf, appointed representative, or third party, document the date and content of your conversation, and to whom you spoke, on an SSA-5002 Report of Contact, the Claim Communication section in eCAT, or the DDS worksheet.

2. When you leave a message

When you leave a message for the claimant, applicant filing on his or her behalf, appointed representative, or third party, 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.

For details about what to include in your conversation or message, see DI 23007.010.

 


To Link to this section - Use this URL:
http://policy.ssa.gov/poms.nsf/lnx/0423007005
DI 23007.005 - Contacting the Claimant, Applicant, Appointed Representative, or Third Party in Claims Involving Failure to Cooperate and Insufficient Evidence - 01/06/2020
Batch run: 02/20/2020
Rev:01/06/2020