DI 30001.205 Quality assurance unit (QAU) High-Risk Case Reviews
In addition to an ongoing random review of all cases, the QAU should review a separate sample of high-risk cases.
A. Definition of a high risk case
High-risk cases are error-prone cases that may involve a particular body system, impairment, workload, development practice, or newly implemented SSA policy. These are just some examples. The DDS Administrator has the flexibility to expand on this definition to meet specific needs.
B. Reviewing a high risk case for QA
Identify high-risk cases through:
analysis of sample case reviews;
headquarters and regional office feedback; and,
supervisory and management input
High-risk cases are selected through special sampling.
3. Handling data
Keep the results of special studies and analysis separate from the routine QA sample.