BASIC (03-01)

DI 33010.001 Receipt and General Review of Claims Folder in the Disability Hearing Unit (DHU)

A. Introduction

Generally, incoming claims folders will be received under cover of an SSA-408.

A clerical/technical review of the claims folder will be made to determine if necessary evidence is included, and to identify existing or potential situations requiring additional action or referral.

B. Procedure

1. Receipt of claims folder

Review the folder for proper routing. If misrouted, send to appropriate DHU or other component.

Update the case control system.

Date stamp the front of the claims folder copy of the SSA-789-U4 to show the date the folder was received in the DHU. (This copy will be inside the claims folder.)

2. Documents and sequence of technical DHU review

  1. Review the SSA-408 for (Route Slip) for “alerts” or identifying remarks.

  2. Use the SSA-887 (Summary of Evidence), if one was prepared by the pre- hearing unit, to check the claims folder to see that all medical/vocational reports listed are in the folder. (Refer to the note in DI 29025.001 1.b. for information on the preparation of the SSA-887.)

  3. Be sure:

    • field office (FO) work development is completed in extended period of eligibility (EPE) cases.

    • an SSA-1696-U4 (Appointment of Representative) form is in the claims folder, if applicable, and that an SSA-1128 (Attorney Representation) is stapled to the folder when a representative has been appointed. (See DI 31001.001 and DI 33010.065 for further information on representation.)

    • appropriate hearing arrangements are made in prisoner cases, e.g., contact with prison officials may be necessary to schedule the hearing.

    • the SSA-4734-BK Residual Functional Capacity (RFC) and SSA-4734-F4-SUP Mental Residual Functional Capacity (MRFC) is included when required (see DI 24510.005, DI 24510.060, and DI 28010.145).

    • the SSA-2506-BK Psychiatric Review Technique Form (PRTF), signed by a medical consultant, is included in all cases involving a current evaluation of a mental impairment (see DI 24505.025 and DI 28010.140).

    • the SSA-538-F6 Childhood Disability Evaluation Form (CDE), is included in all cases involving childhood disability claims (see DI 25230.001)

    NOTE: "ADVISORY" [in bold, upper case letters] will be noted on the following forms in the appropriate sections as outlined in DI 29025.001.1.c, the SSA-4734-BK Residual Functional Capacity (RFC), SSA-4734-F4-SUP Mental Residual Functional Capacity (MRFC), and/or SSA-2506-BK Psychiatric Review Technique Form (PRTF), or SSA-538-F6 Childhood Disability Evaluation Form (CDE).

  4. Interpreters

    Scan the SSA-789-U4 (Request for Reconsideration-Disability Cessation) to determine the need for providing an interpreter. (See DI 33010.030 for instructions on interpreters.)

    Ensure that an interpreter is provided when needed. DHU will provide the interpreter.

    Determine if there is any question regarding the qualifications of an interpreter to be provided by the claimant, and refer the folder to the supervisory hearing officer (SHO) if there is a question.

3. General claims folder review

  1. Review the folder for any other forms, SSA-5002 (Reports of Contact), or SSA-795 (Statement of Claimant or Other Person) form(s) relating to the scheduling of the hearing

    See that appropriate action is or has been taken on requests for changes, waivers of the 20-day advance notice of the hearing and/or appearance at the hearing or cancellations of such waivers.

  2. Translation of Foreign Documents

    Follow DI 33025.015B.2. if foreign documents need to be translated.

  3. Adverse Effect

    Review the claims folder to make sure there are no potentially harmful documents not identified by the disability determination services (DDS).

    NOTE: Such documents may include DDS/FO or other notes as well as reports from doctors and other sources. They may also include nondisability information which may not be released to the claimant. For example, a document showing that an individual does not want his/her whereabouts known to the claimant. Refer any such documents to the SHO so they can be dealt with well before the scheduled hearing date.

    See DI 33015.050 for further instructions on adverse effect material.

  4. d. House cases where the claimant has waived the right to appear at a hearing separately so they are readily accessible to the disability hearing officer (DHO). (These cases should have an SSA-773-U4 (Waiver of Right to Appear - Disability Hearing) in the claims folder.)

NOTE: Any questions resulting or omissions or errors detected from the review in 2 and 3 above are to be referred to the SHO.

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DI 33010.001 - Receipt and General Review of Claims Folder in the Disability Hearing Unit (DHU) - 09/26/2014
Batch run: 09/26/2014