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DI 26530.010 Personalized Disability Explanation Requirements — General

A. Basic Tests

Personalized disability explanations sent to claimant/beneficiaries must meet two basic tests. One, they must be legally sufficient and two, they must not be offensive in any way.

  1. The first test will be consistently met by following the instructions contained in this chapter for preparation of personalized disability explanations in the various claims affected.

  2. The second test involves what is said and how it is said. Abbreviations, acronyms, jargon, technical terms, and complex medical phrases must not be used. The information provided must be relevant, concise and meaningful. Dates may be abbreviated numerically (e.g., 12/14/81), if necessary, to save space. The DDS examiner must be sensitive to the claimant/beneficiary's feelings and needs. Information in the personalized disability explanations must not denigrate these feelings and needs in any manner. The personalized disability explanation should be written in the third person when it is to a person filing on behalf of a claimant.

B. Clarity

In addition to meeting the two basic tests it is equally important that the personalized disability explanation be written as simply and clearly as possible, i.e., understandable to anyone with at least a 6th grade education. Proper use of the English language is also important to avoid conveying an unintended negative message to the claimant/beneficiary. Poorly written notices can have a significant impact on SSA and impair its ability to serve the public interest.

C. Impairments Addressed

The personalized disability explanation should address alleged impairments and other impairments which are discovered during the course of the evaluation provided that the impairments are known by the claimant. Numerous closely related impairments may be grouped by body system.

D. Form Preparation

  1. The office responsible for preparing the determination is responsible for preparing the personalized disability explanation. (See NL 00603.100 for different methods of preparing it.)

  2. Except for merged text notices, the personalized disability explanation should be typewritten on SSA-4268-U4/C4 (Explanation of Determination). SSA-4268-U4/C4 is a full page attachment and every personalized disability explanation should fit on it. Use the guide form in DI 26530.055 as an aid to preparing personalized disability explanations. The guide may be reproduced locally.

  3. The disability decision rationale, will continue to be prepared based on the instructions in DI 26515.001. It will be prepared on another SSA-4268-U4/C4.

  4. When the form number(s) of the preprinted denial letter and rider (when required) are not indicated in Item 29 of SSA-831-U5, write it in the lower left hand corner of the SSA-4268-U4/C4. This is to facilitate association of the complete notice.

E. Specific Case Instructions

For notice and personalized disability explanation instructions for specific case situations (e.g., prisoner cases), see appropriate subchapters in Chapter DI 23501.000.

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DI 26530.010 - Personalized Disability Explanation Requirements -- General - 03/13/2012
Batch run: 03/13/2012