TN 10 (02-11)
DI 30005.237 Correcting Cases with Other Missing or Incorrect Forms
A. Definition of a missing or incorrect form technical corrective action
A missing or incorrect form technical corrective action (TCA) exists when existing Program Operations Manual System instructions require any of the following forms, and other similar case development forms, but the form is not in file or is not fully or properly completed, which includes the Electronic Disability Collect System (EDCS):
SSA-454-BK (Continuing Disability Review Report)
SSA-538-F6 (Childhood Disability Evaluation Form)
SSA-3368-BK (Disability Report - Adult)
SSA-3369-BK (Work History Report)
SSA-3371-BK (Pain Report - Child)
SSA-3375-BK (Function Report - Child Birth to 1st Birthday)
SSA-3376-BK (Function Report – Child Age 1 to 3rd Birthday)
SSA-3377-BK (Function Report – Child Age 3 to 6th Birthday)
SSA-3378-BK (Function Report – Child Age 6 to 12th Birthday)
SSA-3379-BK (Function Report – Child Age 12 to 18th Birthday)
SSA-3441-BK (Disability Report - Appeal)
SSA-3820-BK (Disability Report - Child)
For a further explanation of other missing or incorrect forms TCAs, see GN 04440.239.
B. Policy for correcting cases with missing or incorrect forms
If the review component identifies an electronic case with a missing or incorrect mandatory case development form, as described in DI 30005.237A., the review component returns the determination using an SSA-847-U3 (SSA Request for Case Action) for correction.
If the CDR determination involves a paper case, the review component returns the case to the adjudicating component for correction as follows:
If the case is a continuing disability review (CDR) cessation claim, the review component returns the folder by SSA-847-U3 (SSA Request for Case Action).
If the case is a CDR continuance, the review component sends the SSA-847-U3 to the adjudicating component without the folder.
For a further explanation of corrective action procedure, see GN 04440.239B.
NOTE: If there is an unresolved material discrepancy (i.e., one that could affect the disability determination outcome or the period of disability) between information on the paper form and the EDCS form, the review component cites a group I or group II deficiency.
C. Adjudicating component procedure for incorrect determination forms
1. Denials, reconsideration affirmations, and all CDR cases
When the review component returns a determination with a missing or incorrect form for correction, obtain the properly completed form and:
Return the corrected case to the review component if there is a substantive change in the determination or the case also contains a group I or a group II deficiency, or
Return the case to the appropriate component for timely processing if there is no substantive change in the determination and no group I or group II deficiency exists.
2. Allowance and reconsideration reversals
When the review component returns a determination with a missing or incorrect form for correction:
Obtain the properly completed form, and
Send the form as trailer material to the appropriate component for association with the claim.