DI 29025.001 Disability Determination Services (DDS) Action When Fully Favorable Reconsidered Determination Is Not Issued
A. Case Preparation – Disability Hearing
Continuing Disability Review (CDR) appeals are no longer excluded from electronic folder case processing. Version 12.0 of the EDCS/eView/EFI software provides the capability to process these cases electronically. See Processing a Reconsideration Appeal of an Electronic Continuing Disability (eCDR) Cessation DI 81020.255.
The DDS will take the following actions to prepare a case for the disability hearing:
Ensure proper documentation of the folder. See Documenting the Disability Folder - DDS DI 20503.001.
Enter “ADVISORY” [in bold, upper case letters] on the following forms:
SSA-4734-BK Residual Functional Capacity (RFC) Assessment(s) in section IV, Additional Comments;
SSA-4734-F4-SUP Mental Residual Functional Capacity (MRFC) Assessment(s) in section III, Functional Capacity Assessment;
SSA-2506-BK Psychiatric Review Technique Form (PRTF) in section IV, Consultant’s Notes;
SSA-538-F6 Childhood Disability Evaluation Form (CDEF) in section III, Explanation of Findings.
NOTE: If the assessment form has been imaged into the CEF and cannot be changed, the user will access eView and annotate Advisory in the “Notes” field next to the assessment form. To access the Notes field, the user will click on “Details” and type in Advisory in the note field.
For more information see Processing a Reconsideration Appeal of an Electronic Continuing Disability (eCDR) Cessation DI 81020.255B.1.b. if the case is being processed electronically.
Prepare an SSA-887 Summary of Evidence. (See DDS Action When Fully Favorable Reconsidered Determination is Not Issued DI 29025.001B. and also see SSA-887 (Summary of Evidence) – Exhibit DI 29025.010, for an example of the form).
NOTE: The DDS administrator has the discretion to determine whether the SSA-887 (Summary of Evidence) is completed by the DDS or the Disability Hearings Unit (DHU) within the DDS. If a federal DHU is responsible for issuing the reconsidered determination, the DDS administrator and the regional commissioner must agree whether the Federal DHU or the DDS will perform the function of completing the SSA-887.
B. SSA-887-Summary of Evidence
1. Section A
Complete Section A. as follows:
List all medical reports obtained since the Comparison Point Decision (CPD), including consultative examinations, in chronological order (newest to oldest based on the date of the evidence), then,
List any vocational reports obtained since CPD, then,
List all assessment forms that were required for the case, (e.g., RFC, MRFC, PRTF).
2. Section B
Complete Section B. as follows:
List all medical reports used at CPD, including consultative examinations, in chronological order (newest to oldest based on the date of the evidence), then,
List any vocational reports used at CPD, then,
List all assessment forms prepared at the CPD, (e.g.: RFC, MRFC, PRTF).
NOTE: If the space provided on the SSA-887 is inadequate to show all sources, use the back of the form or a plain piece of paper attached to the SSA-887, to list additional information. If these actions are necessary, indicate what was done in the appropriate block(s) on the SSA-887.
Example: If comments are added for section A., note, “additional comments on attached page” or “additional comments on back”, in section A. If comments are added in section B., note this on the form in section B.
C. Age 18 Re-determinations
The CPD is not relevant in the evaluation of an age 18 re-determination and thus, CPD evidence should not be identified on the SSA-887. Instead, delete any reference to the CPD and list only the current medical and vocational reports, as well as any reports from the previous determination that are used for the current age 18 re-determination.
D. Case Transmission
Follow these instructions to transmit the case to the DHU:
Request that the case control/management unit update the case control system using the appropriate DHU code as the destination code
Use an SSA-408 (Route Slip) to send the case to the DHU and annotate it to alert the DHU to any special situations, e.g., “301”, DA/A, prisoner case. (If the claim is being processed electronically see, Processing a Reconsideration Appeal of an Electronic Continuing Disability Review (eCDR) Cessation DI 81020.255B.1.b.)
Hand-deliver the case if the DHU is co-located with the DDS. Otherwise, mail it or, if possible, use a courier service to speed delivery. Obviously, no such delivery is necessary if the case is being processed electronically.
NOTE: See Detailed Office Organization Resource System (DOORS) Function 20 on the main menu for DHU addresses.