Effective Dates: 08/02/2022 - Present Previous | Next

TN 6 (08-22)

DI 23007.010 A Reasonable Effort to Identify and Involve a Third Party in Claims Involving Failure to Cooperate and Insufficient Evidence

A. When must you make a reasonable effort to identify and involve a third party

Before you stop attempts to get the claimant to comply with your request, you must make a reasonable effort to identify and involve a third party when all of the following apply:

  • •

    The claim falls into a special handling category,

  • •

    The claimant does not have an applicant filing on their behalf or an appointed representative (AR) (A claimant under age 18 requires special handling even when they have an applicant or an AR),

  • •

    The claimant has not already identified a third party on the SSA-3368 (Disability Report - Adult), SSA-3441 (Disability Report - Appeal), or SSA-454 (Continuing Disability Review Report),

  • •

    The Field Office (FO) has not documented that the claimant refused to provide a third party, and

  • •

    The claimant has not complied with your follow up request for evidence or action, or does not attend or confirm a consultative examination (CE) appointment.

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

For when the claimant does not comply with an initial request for evidence or action, see DI 22505.014.

For when the claimant does not comply with the initial notice of a consultative examination (CE) appointment or does not attend a CE appointment, see DI 22510.019.

B. Making a reasonable effort to identify a third party

When DI 23007.010A in this section applies, contact the claimant once by telephone or letter to request a third party contact.

When the FO did not obtain an additional third party, or the FO annotated in the Remarks section "Internet/mailed-in claim - no additional third party contact obtained," you are not required to attempt to identify an additional third party. For the FO policy on documenting third parties, see DI 11018.005F.1, DI 11005.022B, and DI 11005.022C.

When the claimant identifies a third party, make a reasonable effort to involve the third party in accordance with DI 23007.010C in this section.

When the FO documented that the claimant refused to identify a third party, do not attempt to identify a third party. For the FO policy on documenting the refusal, see DI 11005.022B.

NOTE 1: You may ask a claimant that requires special handling to identify a third party at the time you follow up on an initial request for evidence or action, or when you attempt to confirm the claimant's attendance at a scheduled CE appointment (see DI 22510.019).

NOTE 2: When a claimant has not identified a third party on the SSA-3368 (Disability Report - Adult),SSA-3441 (Disability Report - Appeal), or SSA-454 (Continuing Disability Review Report), and the FO did not document that the claimant refused to provide one, you are only required to identify one third party.

1. If you contact the claimant by telephone

Claimant contact by telephone means you either:

  • •

    Speak to the claimant, or

  • •

    Leave a message.

NOTE: Document the date and content of your conversation or message on an SSA-5002 (Report of Contact), a Claims Communication in the Electronic Claims Analysis Tool (eCAT), a Case Note in the Disability Case Processing System (DCPS), or the DDS worksheet.

IMPORTANT: When you do not speak to the claimant and you cannot leave a message, you must contact the claimant once by letter.

a. You speak to the claimant

Ask for the name and contact information of a third party. When the claimant asks for more time to provide this information, give them 10 additional calendar days from the date of your telephone call. Explain that failure to provide the requested information may result in you making a determination based on the evidence in file, which means you may find that the claimant is not disabled.

b. You leave a message for the claimant

You may leave a message on the voicemail recording system of a telephone number in the claim file that is attributable to the claimant. You may also leave a message with an adult who answers a telephone number in the claim file that is attributable to the claimant (e.g., the claimant’s spouse).

Include the following:

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    Your contact information and date that you called. Do not disclose any unnecessary personal information about the claimant,

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    A request that the claimant provide the name and contact information of a third party,

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    A request that the claimant return your call within 10 calendar days from the date of your message with the information, and

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    An explanation that failure to provide the requested information may result in you making a determination based on the evidence in file, which means you may find that the claimant is not disabled.

2. If you contact the claimant by letter

Include the following:

  • •

    Your contact information and date of your letter,

  • •

    A request that the claimant call you within 10 calendar days from the date of your letter with the name and contact information of a third party, and

  • •

    An explanation that failure to provide the requested information may result in you making a determination based on the evidence in file, which means you may find that the claimant is not disabled.

C. Making a reasonable effort to involve a third party

You make a reasonable effort to involve a third party by contacting them by telephone or by letter. This is true even when the third party declines to assist the claimant or does not respond to your contact.

When the FO has identified an additional third party in Section 11 of the SSA-3368 (Disability Report - Adult), Section 10 of the SSA-3441 (Disability Report - Appeal), or Section 11 of the SSA-454 (Continuing Disability Review Report), you must also make a reasonable effort to involve the additional third party when the attempt with the other third party was not productive.

NOTE: How you contact a third party may depend on the information in file. For example, contact a third party by telephone when you only have their telephone number. Likewise, contact a third party by letter when you only have their address. Do not attempt to look up a third party’s telephone number or address in a telephone book or online unless the third party is a professional at a particular location (e.g., a social worker at a specific clinic).

1. If you contact the third party by telephone

Contacting the third party by telephone means you either:

  • •

    Speak to the third party, or

  • •

    Leave a message.

NOTE: Document the date and content of your conversation or message on an SSA-5002 (Report of Contact), a Claims Communication in eCAT, a Case Note in DCPS, or the DDS worksheet.

IMPORTANT: When you do not speak to the third party, and you cannot leave a message, you must contact the third party once by letter.

a. You speak to the third party

Do the following during the conversation:

  • •

    State your contact information. Do not disclose any unnecessary personal information about the claimant,

  • •

    Explain that the claimant told you that you could contact the third party for assistance with the claimant’s disability claim, and

  • •

    Explain that the claimant did not:

    • –

      Comply with your initial request, or follow up request, for evidence or action, or

    • –

      Attend the CE appointment that you scheduled,

  • •

    When the claimant did not comply with your request for evidence or action, identify the evidence or action that you need. When the third party provides a good reason for giving the claimant more time to comply with your request, give the claimant 10 additional days from the date of your telephone call.

  • •

    When the claimant did not attend the CE appointment that you scheduled, explain the CE process and the claimant’s need to attend. When the third party provides a good reason for rescheduling the CE appointment, reschedule the CE.

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    Explain to the third party that if the claimant does not comply with your request(s) for evidence or action, or attend the CE appointment, you may make a determination based on the evidence in file, which means you may find that the claimant is not disabled.

b. You leave a message for the third party

You may leave a message on the voicemail recording system of a telephone number in the claim file that is attributable to the 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 third party (e.g., the third party’s spouse).

Include the following:

  • •

    Your contact information and date that you called. Do not disclose any unnecessary personal information about the claimant,

  • •

    Explain that the claimant told you that you could contact the third party for assistance with the claimant’s disability claim,

  • •

    Explain that the claimant:

    • –

      Did not comply with your initial request, or follow up request, for evidence or action,

    • –

      Did not confirm a CE appointment,

    • –

      Needs assistance getting to a CE appointment, or

    • –

      Did not attend the CE appointment that you scheduled,

  • •

    When you need evidence or action, identify that evidence or action,

  • •

    When you need the claimant to attend a CE appointment, explain the CE process and the claimant’s need to attend,

  • •

    Request that the third party return your telephone call within 10 calendar days from the date of your message, and

  • •

    Explain to the third party that if the claimant does not comply with your request(s) for evidence or action, or attend the CE appointment, you may make a determination based on the evidence in file, which means you may find that the claimant is not disabled.

2. If you contact the third party by letter

Include the following:

  • •

    Your contact information. Do not disclose any unnecessary personal information about the claimant,

  • •

    An explanation that the claimant told you that you could contact the third party for assistance with the claimant’s disability claim,

  • •

    An explanation that the claimant:

    • –

      Did not comply with your initial request or follow up request, for evidence or action, or

    • –

      Did not attend the CE appointment that you scheduled,

  • •

    When you need evidence or action, identify that evidence or action,

  • •

    When you need the claimant to attend or confirm a CE appointment, explain the CE process and the claimant’s need to attend,

  • •

    A request that the third party call you within 10 calendar days from the date of your letter, and

  • •

    An explanation that if the claimant does not comply with your request(s) for evidence or action, or attend the CE appointment, you may make a determination based on the evidence in file, which means you may find that the claimant is not disabled.

To Link to this section - Use this URL:
http://policy.ssa.gov/poms.nsf/lnx/0423007010
DI 23007.010 - A Reasonable Effort to Identify and Involve a Third Party in Claims Involving Failure to Cooperate and Insufficient Evidence - 08/02/2022
Batch run: 08/02/2022
Rev:08/02/2022