DI 42001.010 Material Which Does Not Involve a Reopening
A. Undeliverable letters
When notice to a claimant has been returned as undeliverable, review the related case file for a better address. Where a better (later) address is found, write the address on an SSA-559 and route it with the case folder and letter to the typing unit which prepared the undeliverable notice, for processing in accordance with GN 02605.055 and GN 02605.060. If a better address cannot be found, annotate an SSA-559 “Remail to same address” and forward the SSA-559, letter and case folder to the typing unit which prepared the undeliverable notice for processing in accordance with GN 02605.055 and GN 02605.060. If the notice is returned as undeliverable a second time, it should be annotated “NAN” (no action necessary) and returned to files. Remailing to the same address may be done only once.
NOTE: See GN 03101.020 for finding good cause in extending the 60-day period when a late request for reconsideration is filed in such a case.
B. Letter not received by claimant
Where an individual requests status of his/her claim after notice of determination was previously mailed and was not returned as undeliverable, a reply will be prepared by the appropriate module using NL 00705.505 as a guide. If the original notice was an initial or continuing disability decision, the DE will prepare the reply. If the original notice involves a reconsideration, ALJ, AC or Court decision, the RECONE will have responsibility for the reply.
The examiner having responsibility for the reply to the claimant will prepare the reply using NL 00705.505 as a guide. The folder and the reply should then be routed by SSA-559 to the Clerk-Typist for retyping of the original notice and release of the notice and reply to the claimant.
C. Duplicate application1
A duplicate application is an unnecessary application filed by a claimant for the same benefit for which a previous claim has already been filed. The DO will mark the application “duplicate” and develop any new information appearing on the duplicate which might materially affect adjudication. The duplicate application is a permanent part of SSA's record and must be sent to the PC. The duplicate application will be processed as follows:
If the duplicate application is filed before the date of notice of initial determination on the original application, no action is necessary;
If the duplicate application is filed after an award notice has been sent, the PC will, after reviewing the file to determine whether any additional action is warranted, notify the claimant that his/her rights to benefits were determined based on the prior application on which the award notice was received. No new blanket closeout is needed. No reconsideration paragraph will be included; or
Where a duplicate application is filed after a disallowance notice has been sent, the PC will reexamine the file to verify the correctness of the disallowance determination, taking into consideration any new evidence which may have been submitted. If the determination was correct, the PC will notify the claimant that the new application presents the same issues as the prior application, that prior determination was correct and, accordingly, that favorable action cannot be taken. The letter should include the reconsideration paragraph and state that any subsequent reconsideration will be limited to the question of whether the issue is the same as that previously determined. If it is decided that the issue is not the same, a full determination of the case will be made. The requirement for inclusion of a blanket closeout is applicable.
In any case, where in connection with a duplicate application the claimant submits new and material evidence or it is discovered that the prior determination is incorrect, the initial determination will be reopened if permitted by the rules of administrative finality. Otherwise, action will be taken based on the new application.
D. Duplicate medical
If the new material is a duplicate of evidence already in file and all other actions have been completed, “NAN,” initial, and date the document and return the case to files. If the duplicate information is received by SSA or the DDS more than a month after the date the notice was sent to the applicant, prepare a letter informing the applicant that the evidence was considered in his/her claim.
E. Return to work below SGA
If the claimant submits evidence of work activity with earnings below the SGA level, and these earnings cannot be considered part of the trial work period, the examiner should prepare an SSA-899-U2 and send a letter of continuance.
These inquiries will involve situations where the inquirer asks only for information, status of a case, a report of actions taken, an explanation of the decision, or expresses dissatisfaction with the decision reached with no indication of wanting a reconsideration. If the inquiry (routine or Congressional) pertains to an initial claims issue, the DE will reply to it. If the last determination was a RECONE (ODO) or DEC (DRS), ALJ, AC, or U.S. Federal Court decision, the RECONE/DEC by the Office of Public Inquiries (OPI), will prepare the reply. If the inquiry is OPI controlled, the inquiries specialist will forward the inquiry to the DE or RECONE/DEC as appropriate. Congressional inquiries will be routed under cover of the SSA-3587, Congressional Correspondence.
A prompt and complete reply to inquiries (whether or not OPI-Controlled) will be prepared. Before answering the inquiry, however, review the file carefully to be sure that a proper decision was reached. The file must not be sent to the DDS for review or other action unless there is a proper basis for reopening.
Furnish the applicant with a more detailed and comprehensive explanation of the basis for denial than the explanation previously sent, and if the time limit for requesting reconsideration has not expired, advise him/her of that fact. If additional evidence is submitted, acknowledge its receipt and explain that it does not affect the prior determination. The examiner will instruct the typist to include a copy of pamphlet SSI-58 with the letter. If the time for reconsideration has expired, inform the applicant of the fact and explain that for good cause shown, the time for requesting reconsideration may be extended. Always inform the applicant that any social security office will assist him/her.
1 This section reflects duplicated material.