TN 10 (02-11)
DI 30005.235 Correcting Missing or Incomplete Residual Functional Capacity Assessment or Psychiatric Review Technique Forms
A. Definition of missing or incomplete residual functional capacity assessment and psychiatric review technique forms technical corrective action
A technical corrective action (TCA) exists when the adjudicating component determination requires the SSA-4734-BK (Physical Residual Functional Capacity (RFC) Assessment), SSA-4734-F4-SUP (Mental Residual Functional Capacity Assessment), or SSA-2506-BK (Psychiatric Review Technique), but it is not in file, or it is in file but not all required entries on the form are completed. This TCA is linked to the proper completion of the forms and does not encompass whether the RFC assessment or the level of psychiatric impairment severity is correct, as explained in GN 04440.238B.
B. Policy for correcting the TCA
The review component may assume jurisdiction and prepare the missing or incomplete forms if they have the capacity to do so. Regardless, the review component returns the case to the adjudicating component for correction if, in the judgment of the Office of Quality Review Field Management, the adjudicating component is frequently adjudicating cases with missing or incorrect RFC assessment forms or psychiatric review technique forms (PRTF). For a further explanation of corrective action policy, see GN 04440.238B.2.
C. Adjudicating component procedure for correcting medical determination forms
Complete the mandatory form as requested on the SSA-847-U3 (SSA Request for Case Action).
Place the properly completed form in file. The original PRTF or RFC should remain in file as part of the audit trail. (The review component will annotate the original form, “Do Not Process”.)
Clear the case to the appropriate component.
Do not return the case to the review component unless instructed to do so.