TN 8 (04-04)
DI 30005.201 General Rules for Routing And Correcting Deficient Cases
This section provides guidelines for routing and correcting cases that contain a group I, group II or group III deficiency. Sections DI 30005.210 - DI 30005.231 provide detailed instructions for correcting specific types of group I, group II and group III deficiencies. See Section GN 04440.000 for a list of acronyms a quality reviewer may use in their return forms.
1. Group I deficiencies
All group I decisional deficiencies and documentation deficiencies are returned for correction either to the adjudicating component or to the FO.
2. Group II deficiencies
Group II period of disability deficiencies are returned for correction either to the adjudicating component or to the FO. However, in certain instances, the review component will correct group II onset date and ending date decisional deficiencies. See DI 30005.220 and GN 04440.222.
3. Group III deficiencies
Some TCAs are corrected by either the adjudicating component or the review component and some TCAs do not require any corrective action. See GN 04440.230 to GN 04440.243 for additional information.
4. Non-Recorded deficiencies
Non-recorded deficiencies are either returned to the adjudicating component for corrective action or are corrected in the review component. See DI 30005.232 for an explanation of non-recorded deficiencies.
C. Procedure - DDS
Take the corrective action requested on the deficiency transmittal form and return to the review component all corrected group I and group II deficiency cases.
NOTE: The original PRTF and/or RFC should remain in file as part of the audit trail. The original should be annotated “Do Not Process”.
D. Procedure - review component
The review component will follow up on all group I and group II deficient cases forwarded to the adjudicating component for correction, as follows:
Group I and group II documentation deficiencies – 60 calendar days after the case was sent to the adjudicating component.
Group I and group II decisional deficiencies – 30 calendar days after the case was sent to the adjudicating component.