TN 48 (11-94)

DI 32594.040 Miscellaneous DDS Procedures


Follow miscellaneous procedures as shown below:

1. Inquiries - general

  1. Respond to any inquiry that does not pertain to status of individual's State of New York case.

  2. In requesting information from automated systems, use LNA - LNF of “825” to identify class action.

  3. If folder request is necessary, obtain via DDSQ facility. See SM 06002.000.

2. Inquiries about status - State of New York case

  1. If folder is in DDS, associate inquiry about the status of the State of New York cases with folder and respond in writing.

  2. If folder is not in DDS:

    • DDS should contact NYRO DPB - (212) 264-7299.

    • Based on information provided by State of New York Coordinator, prepare written notice giving status of inquirer's State of New York case.

    • Forward inquiry and copy of response to current folder location. If case has not yet been alerted, send material to:

      P.O. Box 17369
      Baltimore, Maryland 21298-0050.

3. Work within 12 months

  1. If individual returned to work within 12 months after onset and FO has not evaluated work, send folder to FO for evaluation of work.

  2. If FO has determined that work, which began within 12 months after onset, is SGA and continues through present, return case to FO for revision of original determination to SGA denial.

4. Class member represented

  1. Examine folder for current or prior indication of representation. Review SSA-1696-U4, correspondence or statements made by individual.

  2. If indication of representation is from prior file, ask class member whether he or she is still represented by the same party.

  3. Send SSA-1696-U4 to individual for completion if:

    • indication of representation is found on other than SSA-1696-U4, or

    • class member indicates representation by someone other than representative of record.

  4. If class member is currently represented, conduct any development through the representative. Send copies of all notices to the representative (see DI 32594.035 A.).

5. Class member dies before readjudication

If class member dies before readjudication:

  1. Contact FO to locate survivors, qualified substitute party, representative payee, and/or legal representative, if any.

  2. Ask FO to obtain death certificate.

  3. Do not send folder to FO unless FO requests it.

  4. If none of the individuals described in a. above is located, process as “no determination” and return folder to PC.

  5. If there are any questions about additional evidence:

    • Contact relevant party for information.

    • Consider whether death may indicate that class member's condition was worse than believed at time of prior final determination.

  6. Title II cases - Prepare determination if responsible party is located. (See DI 23510.001 A.)

  7. Title XVI cases - Prepare determination if FO returns case for determination.

6. Claimant chooses to pursue current claim independently of State of New York case

If situation in DI 32594.005 B.3.b. or d. exists,

  1. Do not request current claims folder.

  2. Process State of New York case as no-determination.

  3. Send State of New York folder to OHA for their review as to whether any evidence in State of New York folder might be relevant to period adjudicated by OHA on current claim.

  4. Advise OHA to return all folders to DDS for State of New York readjudication after effectuation and after period to appeal determination on current claim has expired.

  5. Upon return of folders to DDS, readjudicate State of New York case without regard to OHA decision.

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DI 32594.040 - Miscellaneous DDS Procedures - 02/21/2013
Batch run: 02/21/2013