TN 10 (02-11)
DI 30005.239 Correcting Mental Impairment Case Technical Corrective Actions
A. Definition of a mental impairment case technical corrective action
The Social Security Disability Benefits Reform Act of 1984 requires the Commissioner, before determining that the individual is not under a disability, to make “every reasonable effort to ensure that a qualified psychiatrist or psychologist completes the medical portion of the case review and any applicable residual functional capacity (RFC) assessment” if the evidence indicates a mental impairment exists.
For a further explanation of this requirement, see the following references:
DI 24505.025A, Evaluation of Mental Impairments
DI 24505.030B, Expedients to Evaluate and Develop Evidence for Potential Mental and Physical Impairments
A mental impairment case contains a technical corrective action (TCA) when:
The disability determination is unfavorable or less than fully favorable;
The evidence indicates a mental impairment exists; and
A qualified psychiatrist or psychologist did not review the claim in the adjudicating component.
For a further explanation of a deficient mental impairment case, see GN 04440.240.
B. Policy for correcting mental impairment case TCAs
If a qualified psychiatrist or psychologist has not reviewed an unfavorable or less than fully favorable determination involving a mental impairment, the review component either:
Assumes jurisdiction and has the appropriate medical consultant review the case, prepare any necessary forms, and adjudicate the case; or
Returns the case to the adjudicating component for correction.
If it is not clear that the signing physician is a qualified physician or psychologist, the review component calls the adjudicating component to verify the physician's specialty. If the signing physician is not a qualified psychiatrist or psychologist, the review component takes appropriate action to correct the file or have the file corrected. For a further explanation of corrective action procedures, see GN 04440.240C.
C. Adjudicating component procedure for missing signature on medical assessment forms
When the review component returns a determination to obtain the signature of a qualified psychiatrist or psychologist, or to obtain their case review:
Obtain the form(s) or signature indicated in the SSA-847-U3 (SSA Request for Case Action);
Clear the case to the appropriate component; and
Do not return the case to the review component unless instructed to do so.
NOTE: The original Psychiatric Review Technique Form or RFC should remain in file as part of the audit trail. The review component will annotate the original, “Do Not Process.”