TN 38 (09-15)

DI 28030.015 Contact with the Individual

A. Initial contact with the individual

Contact with the individual (or his or her representative) is generally initiated by a personal interview in the Social Security field office (FO). At that time, the individual receives an explanation of the continuing disability review (CDR) process and information concerning his or her rights and responsibilities. The FO records and includes pertinent information about the individual's medical condition and vocational background in the case folder.

NOTE: MINE (medical improvement not expected), or MINE-equivalent cases usually will not require personal interview at the FO.

Upon receipt of the case from the FO, the disability determination services (DDS) reviews the information obtained during the personal interview and begins development of the medical evidence by contacting the appropriate medical sources.

If the DDS finds that information contained in the case file is not sufficient for adjudicative purposes (for example, vocational documentation is not complete), contact the individual (or his or her representative) by telephone or by mail. If the contact is by telephone, annotate the name of the individual and the information received on a SSA-5002 (Report of Contact). Sites that use the electronic claims analysis tool (eCAT) may document this telephone conversation in a claims communication.

B. DDS requests assistance from the FO or another DDS

When the DDS has difficulty obtaining needed information from an individual or representative, request assistance from another component (the FO or another DDS). The DDS may need to request assistance from other components in the following situations:

  • The individual has not responded (after appropriate follow-up by mail or telephone) to requests for information.

  • The individual's response is inadequate to resolve the raised issues.

  • The DDS needs to secure specific information, and believes the other component is in a better position to obtain it.

  • To obtain medical evidence from certain sources.

  • To arrange a consultative examination (CE) across state lines.

The DDS initiates an electronic assistance request (AR) using their case processing system. The initiating DDS may also make request by telephone, and confirm by mail using a Form SSA-883-U3 (Request for Evidence or Assistance (Disability Case)). Requests for assistance should specify exactly what information the DDS needs for adjudication.

The initiating DDS receives an alert when the receiving office completes the AR and adds the reply to the electronic folder (EF). The receiving component may also respond by telephone, email, or mail based on the nature of the request.

C. References


To Link to this section - Use this URL:
http://policy.ssa.gov/poms.nsf/lnx/0428030015
DI 28030.015 - Contact with the Individual - 09/08/2015
Batch run: 09/08/2015
Rev:09/08/2015