TN 2 (02-04)

SI 04020.040 Case Review

A. Definition—case review

Case review is a method of reconsideration involving a thorough review of all evidence in the file, including evidence submitted by the claimant, his/her representative or otherwise secured by SSA.

B. Policy

SSA will give the claimant and all other parties to the reconsideration an opportunity to review the evidence in our files and then to present oral and written evidence. The official who reviews all of the evidence will make a reconsidered determination.

C. Procedure

1. Reviewing the File

Upon request, offer the claimant, his/her representative and all other parties to the appeal and their representatives the opportunity to review the file in the office and to supply additional evidence as soon as possible.

If additional evidence is promised, give the claimant a reasonable amount of time to supply it.

2. When Additional Evidence or Information is Submitted

Document the additional information or evidence on the AMAD (More Appeal Data). If the information is offered verbally, assist the claimant in completing an SSA-795 for folder documentation. If the person does not wish to sign a statement, record that fact on the RPOC screen.

NOTE: For instructions on handling additional evidence for a disability claim that is pending administrative review, see DI 51501.015 - Claimant Submits Additional Evidence.

3. Reasonable Time

Ask the claimant to submit additional evidence within 10 days. Allow additional time if the claimant needs it but determine how much additional time is needed, i.e., 10 days, 15 days, etc). Annotate the date expected on the AMAD (More Appeal Data) screen. If the evidence is not received, and the claimant or representative does not notify the FO of the efforts to obtain it, send the claimant a notice explaining that he/she has an additional 15 days to submit the additional evidence and that after 15 days, we will conduct the case review and render a reconsidered determination.

Obtain or assist the claimant in obtaining the evidence if it is easier for the FO to obtain it or the claimant needs assistance in obtaining it.

4. Timeframe for Conducting Case Review

Conduct the case review within 5 workdays after all evidence and/or information is submitted.

5. Documentation and Notice

  • Complete Form SSA-8450 (District Office Record of SSI Reconsideration). The SSA-8450 is only necessary in non-MSSICS cases (see SI 04020.050 E.9),

  • Prepare and release a manual notice on Form SSA-L8455-U2, SSA-L8456-U2 or SSA-L8457-U2 .

  • Make the necessary system input (see MSOM MSSICS 020.001 for MSSICS screens).


To Link to this section - Use this URL:
http://policy.ssa.gov/poms.nsf/lnx/0504020040