TN 8 (04-04)

DI 30005.411 Routing Determination Forms - DDS Procedure

If you prepare a new determination form SSA-831-C3/U3, SSA-832-C3/U3, SSA-833-C3/U3 or Form SSA-4268-U4/C4 (Explanation of Determination):

  • Retain the "State Agency/Data Copy" of the form.

  • Do not remove the original SSA-831-C3/U3, SSA-832-C3/U3, SSA-833-C3/U3 or SSA-4268-U4/C4 from the folder.

  • Enter in item 34 of the original disability determination form "Do Not Process." In addition, place a large "X" across the form.

  • Place a large "X" across the original SSA-4268-U4/C4 when a new SSA-4268-U4/C4 is prepared and staple the original SSA-4268-U4/C4 to the original disability determination form.

  • Prong file the original SSA-831-C3/U3, SSA-832-C3/U3 or SSA-833-C3/U3 and SSA-4268-U4/C4 in the front yellow section of the modular disability folder (or on the right side of the brown folder).

See DI 26510.000 for assistance with determination form completion.

To Link to this section - Use this URL:
DI 30005.411 - Routing Determination Forms - DDS Procedure - 03/14/2012
Batch run: 03/14/2012