BASIC (04-13)

DI 31005.005 Disability Determination Services (DDS) Procedures for Handling Inquiries from Claimants or an Appointed Representative

NOTE: Regional procedures for implementing this policy may vary.

A. Responding to an inquiry if the claim is in the DDS

1. When to respond to an inquiry

Respond to inquiries addressed to the DDS, which relate to:

  • disability claims processing, and

  • disclosing medical information.

When responding to these inquiries, follow the instructions in GN 03300.000 and DI 81001.030. You may need to contact the field office (FO) for assistance if you need additional information to respond to an inquiry.

2. When not to respond to an inquiry

Do not respond to inquiries from the claimant’s representative regarding:

  • specific payment data,

  • denied claims when a request for reconsideration or hearing is implied, but has not been filed, and

  • disability determination information if claim processing is incomplete.

Contact the inquirer to provide an interim status update according to the instructions in DI 310005.005B and forward the inquiry to the FO for a response.

NOTE: Use the telephone whenever possible to acknowledge receipt of an inquiry or to provide status. Provide an interim response if the inquirer requests detailed information or if there may be a delay with the final reply.

3. Routing a claim after receiving an inquiry

Receiving an inquiry normally does not alter the procedures for routing a claim after all applicable claim action(s) are completed. Continue to route the claim folder according to existing electronic folder instructions in DI 81020.125, DI 81020.127, and DI 81020.130 or the paper folder instructions in DI 32005.025.

B. Responding to an inquiry if the claim is in another office

Inform the inquirer the DDS forwarded the claim to another office and take the following action(s):

  • forward the inquiry to the office with jurisdiction of the claim for a response;

  • advise the inquirer to contact the servicing FO if he or she has further questions about the claim; and

  • for electronic claims add an alert to the electronic folder according to the instructions in DI 81020.080; or

  • for paper claims complete an SSA-408 (Route Slip) and annotate with the comment: “Inquiry – Action Needed;” and

  • forward a copy of the reply and the inquiry to the office in possession of the claim.

C. Responding to an inquiry if there is no record of a paper claim

If, you cannot find a record of the paper claim after a thorough search, inform the inquirer you are sending the inquiry to the FO for reply. If you cannot determine the servicing FO:

  • complete an SSA-408, annotated with the remark: “Please respond to inquiry, no record of a claim in our office;”

  • attach the SSA-408 to the inquiry; and

  • send the inquiry and a copy of the acknowledgement to the parallel FO (in the locality of the DDS) for forwarding to the proper FO.

D. Responding to an inquiry about Social Security Administration (SSA) programs

If an inquiry contains general questions or criticisms about SSA programs not related to a specific claim, acknowledge the inquiry and take the following actions:

  • Electronic claims - complete an electronic assistance request according to the instructions in DI 81020.100; or

  • Paper claims - send the inquiry and a copy of the acknowledgement to the regional office , using a Form SSA-408; and

  • Include the remark: “Please respond to the inquiry.”

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