TN 7 (09-97)

DI 33015.010 Disability Hearing Officer's Review of the Claims Folder

A. Policy

Prior to the hearing, the DHO receives the claims folder to review. This review is for the DHO to become familiar with relevant evidence and to pinpoint the key issues expected to arise in the hearing.

If the evidence supports a fully favorable decision, and if the claimant/representative is already in the DHU, the DHO proceeds with the hearing. The DHO's decision is not annotated to show that a fully favorable decision could have been made without holding a hearing.

B. Procedure

Review the claims folder as described below.

1. Review materials

Review the following materials:

  • the SSA-408 (Route Slip) used to transmit the folder to the DHU for any special situations, e.g., 301, adverse effect material, drug addiction and alcoholism (DAA), etc.

  • the SSA-454-BK (Continuing Disability Review Report), the determination under appeal and rationale, and the notice to the claimant.

  • "SSA-789-U4 (Request for Reconsideration Disability Cessation), the claimant's basis for filing for reconsideration as well as supporting statements on the SSA-3441-BK (Disability Report - Appeal) replaced the SSA-782-BK. This should supplement the SSA-454-BK (Continuing Disability Review Report). Be sure to note the FO observations on both of these reports. the determination under appeal and rationale, the notice to the claimant, and the SSA-454-BK.

  • the SSA-887 (Summary of Evidence) (see DI 33095.045 for an exhibit of the form).

  • relevant medical/vocational information.

2. Residual functional capacity (RFC) assessment

Review the new DDS RFC assessment which should be in file unless:

  • the DDS considers that the impairment is “not severe,” or

  • the individual is “statutorily blind.”

NOTE: The DDS will have labeled this RFC assessment "ADVISORY" [in bold, upper case letters], in section IV, Additional Comments, when the case is prepared and sent to the DHU. If there is a SSA-2506-BK Psychiatric Review Technique Form (PRTF), it will also be labeled "ADVISORY" [in bold, upper case letters] in section IV, Consultant's Notes. (See DI 29025.001 1.c. for additional forms.)

3. Read the folder

Read the entire claims folder to ensure that a complete picture has been obtained, and that the Summary of Evidence is complete and accurate.

To Link to this section - Use this URL:
DI 33015.010 - Disability Hearing Officer's Review of the Claims Folder - 04/16/2013
Batch run: 03/07/2014