TN 14 (08-92)

DI 40510.142 Locating Folders

A. Policy - folder retention

1. Folder retention period

Based on the Commissioner's decision dated April 25, l988, the retention period for inactive files on denied or terminated title II RSI and DI cases is 5 years.

2. Exceptions

Exceptions to this retention period are:

a. ODIO jurisdiction

Title II disability folders under ODIO jurisdiction prior to 1979 have been destroyed.

NOTE: Potential entitlement cases for the period from 1979-1984 have been identified to prevent their destruction on a temporary basis.

b. PSC jurisdiction

Title II RSI and DI folders under PSC jurisdiction prior to l984 have been destroyed.

NOTE: Court cases for 1973-1984 have been saved.

B. Policy - folder not available

1. Folder search

ODIO and PSCs follow normal search procedures to locate the necessary folder(s).

2. Lost folders

  1. Claims folders are to be reconstructed only after it has been determined that the original folder is irretrievably lost.

  2. An original folder is considered lost after all possible search methods available have failed to locate the original folder.

3. Destroyed folders

If the folder has been destroyed, in the absence of any indication of medical improvement (MI), the individual is deemed enrolled for Premium-HI if the individual cannot otherwise be screened in (see D.3. below).

C. Procedure - lost folders

1. Search efforts

If the folder is lost:

  1. Obtain a readout and attempt to obtain the necessary folder(s) based on the readout before screening in.

  2. If the folder cannot be located based on the readout, before continuing with a full-scale lost folder search:

    • determine if the individual filed in the proper enrollment period per DI 40510.145B, and

    • verify cessation reason per D. 2. below.

  3. If the individual filed in the proper enrollment period and was ceased for SGA:

  4. Continue with the full-scale lost folder search per DI 40525.020B.

2. Folder located

If the folder is located:

  1. Review the original folder to verify eligibility per DI 40510.145.

  2. If not eligible, terminate premium Medicare effective with the end of the month after the month in which the individual is notified he/she is not eligible.

3. Folder not located

If the folder is not located:

  1. Do not send to FO for reconstruction.

  2. Obtain current medical evidence of record per DI 40510.165 B.2.

  3. When the medical evidence is returned, follow DI 40510.155 B.1.a.

  4. If the individual still cannot be screened in:

  5. Determine the comparison point decision (CPD), if possible and begin reconstruction of the prior evidence.

  6. Since current medical evidence has already been obtained, instruct the FO to:

    • conduct a personal contact interview with the individual and to obtain information and documents regarding prior medical decisions; and

    • obtain medical treatment sources for at least the 12 months preceding the CPD.

D. Procedure - destroyed folders

1. Verifying enrollment period

Determine if the individual filed in the proper enrollment period per
DI 40510.145B.

2. Verifying cessation reason

In order to verify a cessation reason, obtain an MBR and SSA-454-BK and review them in detail. If necessary, obtain an SEQY/DEQY to verify work history.