BASIC (01-01)

DI 40525.075 Step Three - Preparing Duplicate Folder for CDR Lost Folder/Medical Evidence

A. Background

OCO and the PSCs are important links in upholding the integrity of SSA"s disability decisions/determinations and continuing payments of disability benefits. Finding or replacing missing/misplaced medical folders is extremely costly, as is erroneous continuation of medical disability benefits to an individual who is no longer disabled, but continues in pay because the CPD medical folder cannot be found.

B. Procedure

1. PCACS shows no folder was created

If the Processing Center Action Control System (PCACS) shows that no folder was created, the claim may be an electronic folder. Check eView to see if there is an electronic disability folder. If an electronic disability folder exists, discard the alert and read the ACR FIN. If no electronic disability folder exists, prepare a new yellow six-part Modular Disability Folder (if available), with an original bar code label. Send the folder and the alert to the FO. Read the ACR FIN.

2. Search for medical folder – OCO/PSCs of jurisdiction

For follow-up purposes and to reduce duplication of effort, document on the SSA-5002 (see DI 40525.125) all your efforts to locate the folder(s). Circle/highlight pertinent data/information, e.g., on the NUMI circle/highlight any name change. Keep all reports of telephone calls, and other pertinent material and queries in file.

NOTE: Even though the procedure in the remaining sub-chapters specifies which job disciplines are to perform certain functions, OCO/PSC/DRS management can assign these tasks to any job discipline. The assignments are at the discretion of the local management team.

3. Special search unsuccessful – no folder (PCACS reads "AUXRH QUES QUES", or "AUXRH TEMP QUES" or " CAVES QUES QUES" or “PC1-6 QUES QUES”) - duplicate folder needed – CRT/FLC/DSE actions

Take the following actions:

  1. If the search for the medical folder is unsuccessful (not to exceed 120 days), prepare a duplicate folder.

  2. Staple the direct release/mailer alert to the front of the folder. File the Special Search report with any attached documents in the duplicate folder.

  3. Record the duplicate folder to PCACS location MODXX DE BKLG (i.e., given to the OCO modules DEC/DE or to location DRS DE PROC in the PSC DRS).

  4. Forward the duplicate folder to the DSE employee or the DE/DEC.

4. Special search unsuccessful – no folder (PCACS reads "AUXRH QUES QUES", or "AUXRH TEMP QUES", or " CAVES QUES QUES", or “PC1-6 QUES QUES) – duplicate folder needed – DSE or DE/DEC actions

NOTE: If preparation and receipt of the duplicate folder exceeds fifteen working days, FOs may contact OCO/PSC DRS by phone for an update on the current status of the Title II folder.

Take the following actions:

  1. Select number 32 (Continuing Disability Review File) from the SSA MAIN MENU and hit the “Enter” key.

  2. Key “01” (QUERY) and complete the SSN, key the BIC only if it is other than "A", and hit the “Enter” key.

  3. At the ECDR screen, hit the “Enter” key.

  4. At the QCDR screen, write down the most recently dated 3-digit “DESTINATION” code that is found under the EVENT area of the screen hit the “Enter” key.

    EXCEPTION: If the “DESTINATION” code is “732” ignore it and use the jurisdictional FO instead.

  5. If in the "remarks" screen, hit the "enter" key to get back to the MCDR screen.

  6. Once at the MCDR screen, key “03” (PC UPDATE) and complete the SSN, key the BIC only if it is other than "A", and hit the “Enter” key.

  7. At the ECDR screen, hit the “Enter” key.

  8. At the IPCA screen, in the "SELECT EVENT TYPE", key “01” to transfer the case.

  9. The cursor will MOVE to the "FOLDER RECONSTRUCTION ISSUE" field which should contain a "Q". Change the “Q” to an “L” and hit the “Enter” key.

    NOTE: If the "FOLDER RECONSTRUCTION ISSUE" field does not currently reflect a "Q", as indicated above, DSE or DE/DEC still ENTERS the "L", because the duplicate folder is going to be forwarded to the FO. An “L” in the "FOLDER RECONSTRUCTION ISSUE" field of the Disability Control File (DCF) indicates that the medical folder is lost.