DI 28084.065 Disability Determination Services (DDS) Selections of Quality Assurance (QA) Sample Cases and Case Processing
A. Background for selecting QA sample cases
All continuing disability review (CDR) cases are subject to selection for QA review, which the Office of Quality Review (OQR), Disability Quality Branches (DQB) performs on a pre-effectuation basis. The Automated Sample Selection Process module of the National Disability Determination Service System (NDDSS) considers each case for sample selection. DDSs will receive an alert of the sample selection, if cases receive selection for QA review.
B. Procedure for handling QA sample cases
Forward selected sample cases to the appropriate DQB for review. Prepare notices in the usual manner. Do not release notices prepared on QA sample cases. File these notices in the paper folder and clip them to mailing envelopes containing zip codes 21235-6401 (Title XVI notices) or 21241-1500 (Title II notices), as applicable. For electronic cases involving a review and dating the personalized disability notice, see DI 81020.130D. The OQR review component releases the notices after the review is completed.
NOTE: For information about storing notices in the Electronic Disability Case System (EDCS), see Electronic Case Closure in section DI 81020.130.
C. Procedure for non-sample QA cases (paper cases)
Follow these procedures when a non-sample QA case is involved:
1. Continuances and cessations - benefit continuation does not apply
Follow these instructions:
Attach a Form SSA-408 (Route Slip) to the folder in continuance cases and enter "Continuance Refile" in the remarks section of the Form SSA-408 (Route Slip); and
Use a Form SSA-408 (Route Slip) when routing a cessation that does not apply to benefit continuation.
2. Cessations - benefit continuation applies
Follow these instructions:
Route the folder under the cover of an SSA-832 (Cessation or Continuance of Disability or Blindness Determination and Transmittal –Title XVI) or SSA-833 (Cessation or Continuance of Disability or Blindness Determination and Transmittal – Title II).
Show in the remarks section "Cessation Determination(s)" and the remark under the following applicable case category:
Title XVI only: "Input “N07” or “N08” for Title XVI benefit termination, in accordance with SM 01305.001.";
“Concurrent (Title II/Title XVI) case involving a Title II Primary Beneficiary (HA)”; or
“Concurrent (Title II/Title XVI) case involving a Title II auxiliary beneficiary (disabled widow(er) beneficiary (DWB) or childhood disability beneficiary (CDB))”.
For case routing and notice release instructions, see DI 32010.000.