TN 16 (05-93)

DI 40505.020 FO/DDS Deferral, or Discontinuance

See DI 55025.010 for medical CDR processing instructions for beneficiaries with Tickets to Work.

A. Introduction

With the introduction of the CDR mailer process (DI 40502.000), medical CDR alerts no longer require screening. The PC reviews the completed mailer and profile data sheet to decide when full medical CDRs are required. If a full medical CDR is not necessary, the case is re-diaried. Based on PC input, the system produces alerts only for those cases in which full medical CDRs are needed. References to FO screenout and discontinuance have been deleted. However, there are still instances in which an FO may defer, or DDS may discontinue a CDR.

1. Deferring case

The FO may defer a CDR if it would be inappropriate or very inconvenient due to beneficiary hospitalization, travel, etc. With RO approval, the FO may also defer a case in life-threatening situations (DI 13005.020). A case can be deferred for up to 6 months.

2. CDR discontinued

  1. a. 

    The DDS ordinarily completes all CDRs received from the FO, but may discontinue a CDR if the case is particularly sensitive (e.g., AIDS or any other terminal impairment).

  2. b. 

    The component responsible for discontinuing the CDR must notify the beneficiary.

B. Procedure

If the CDR is returned from the FO or DDS:

  • Verify the reason for return. Do not review a decision to defer.

  • Re-diary as appropriate (no more than 6 months for a deferral), or

  • Return cases to the FO or DDS if the basis for discontinuing the CDR is incorrect. Explain in the file the reason for the return.

To Link to this section - Use this URL:
DI 40505.020 - FO/DDS Deferral, or Discontinuance - 09/16/2002
Batch run: 03/07/2014