TN 62 (02-97)

DI 32521.030 Miscellaneous Procedure

Procedure

1. Lost folders

After the FO completes folder reconstruction, the FO forwards the reconstructed claim to the DDS. The DDS will:

  1. Reconstruct the evidence for the reopening period. Do not secure medical evidence for periods beyond full retirement age or the date last insured.

  2. Contact ONLY those doctors, hospitals, etc., identified by the class member. DO NOT reconstruct the names of doctors, medical centers, etc., that a claimant may have visited when the claimant is now unable to recall that information.

    If no response is received from the initial request, make one follow-up by letter (or phone call) (see DI 22505.001). If the evidence received from the treating source(s) or other medical source(s) is insufficient for adjudication, recontact the source(s) for additional information. DO NOT obtain a consultative exam if the request for information is unsuccessful.

  3. Conduct the Dixon review based on the reconstructed file.

    When readjudicating the Dixon claim(s), ONLY consider subsequent impairment(s) that can reasonably be said to be related to the impairment(s) which provided the basis for the determination in the Dixon claim(s). (See DI 32521.015B.2.c. regarding subsequent impairments.)

  4. If the file cannot be reconstructed:

    • Adjudicate the claim based on current evidence, and

    • If disabililty is established, establish the earliest possible onset reasonably supported by the evidence.

2. Whereabouts unknown

If the claimant's whereabouts become unknown anytime during the adjudication process:

  • Follow DI 23005.001 and DI 28095.050 for instructions on processing whereabouts unknown cases.

  • If the reopening is unfavorable, prepare a Form SSA-831/832/833-U3, as appropriate, and a personalized notice. Send the notice to the class member's last known address. Also send a copy to class counsel. Make systems input per DI 32521.010 and send the folder to the servicing FO to retain during the appeals period.

  • If a favorable reopening is possible, request FO assistance to locate the claimant. If the claimant is not located, complete any development not requiring claimant participation and prepare a determination based on the evidence in file.

  • If the class member has died, see number 3 below.

3. Deceased class member

If a class member dies prior to adjudication, request the FO to determine if an underpayment is payable per GN 02301.055A and SI 02101.003, as appropriate.

4. Failure to cooperate

In failure to cooperate situations:

  1. Follow DI 23010.005 thorugh DI 23010.025.

  2. Adjudicate the claim based on the evidence available.

5. Representative involved

Send copies of all correspondence to any representative(s). Obtain Form SSA-1696-U4 (Appointment of Representative), if one is not in file.

NOTE: Any development requests will be made following the guides in DI 22505.001. Case development requests must be through the representative unless he or she indicates otherwise.

6. Screening

Take the following actions if ODIO and/or NEPSC sends the alert/query package to the DDS because the prior Dixon claim(s) has been associated with a current claim pending in the DDS:

  1. Screen Dixon claim(s) for class membership and complete a screening sheet in duplicate (see DI 32521.095, Exhibit 5).

  2. Place the original of the screening sheet in file and forward a copy to ODIO at:

    SSA, ODIO
    Class Action Section
    Attention: Dixon Coordinator
    P.O. Box 17369
    Baltimore, Md 21298-0050
  3. If the Dixon claim(s) is screened-in, conduct the Dixon review per DI 32521.015.

  4. If the Dixon claim(s) is screened-out, send a non-class membership notice to the claimant, any representative(s), and class counsel.

    NOTE: If there are multiple Dixon claims and at least one claim is screened-in, do not send a "Non-class Membership Notice" for the other claim(s) that is screened-out.<