PROGRAM OPERATIONS MANUAL SYSTEMPart DI – Disability InsuranceChapter 230 – Special IssuesSubchapter 05 – Whereabouts UnknownTransmittal No. 10, 01/10/2020
This is a Quick Action Transmittal. These revisions do not change or introduce new policy or procedure.
Summary of Changes
DI 23005.001 Processing Whereabouts Unknown Disability Cases
We revised the title of DI 28075.005 at the beginning, the reference for claimants who require special handling in DI 23005.001C, and the reference/title in DI 23005.001E for consistency with the revised FTC policy.
This section addresses how the DDS processes whereabouts unknown disability cases. However, there are specific instructions for continuing disability reviews. For instructions on whereabouts unknown situations in continuing disability reviews, refer to DI 28075.005 Failure to Cooperate (FTC) and Whereabouts Unknown (WU) During a Medical Continuing Disability Review (CDR).
Consider the claimant’s whereabouts unknown if we cannot locate the claimant at the last known address and after completing all required actions to locate the claimant.
When a claimant’s whereabouts become unknown while the FO is developing the claim, the FO reviews the case to establish if the disability determination services (DDS) must make a medical determination.
Prior to routing the file to the DDS, the FO must:
Make a substantial gainful activity (SGA) determination;
Provide an accurate potential onset date (POD); and
Review the file documents.
If the FO is unable to evaluate SGA and provide a correct POD, the FO must deny the claim.
The FO must ensure that the file contains:
Completed disability report forms (SSA-3367 (Disability Report- Field Office) and SSA-3368 (Disability Report- Adult), SSA-3441 (Disability Report- Appeal), or SSA-3820 (Disability Report – Child)); AND
Signed form SSA-827 (Authorization to Disclose Information to the Social Security Administration (SSA)); or
Medical evidence (as described in DI 22505.001).
When a claimant’s whereabouts become unknown after the case arrives at the DDS, the DDS chooses to attempt to locate the claimant, or if necessary, requests FO assistance in locating the claimant. If the DDS chooses to attempt to locate the claimant, the DDS must document its efforts and outcomes in the case folder.
Attempts to locate the claimant before or while requesting FO assistance.
Must consider special handling situations when determining whether FO involvement is necessary (see DI
Subsequent federal quality reviewers will not cite a deficiency if DDS chooses not to attempt to locate a claimant before or while requesting FO assistance.
Examples of actions the DDS takes when choosing to locate the claimant:
Mail a form SSA-L2001 (Address Information Request) to postmaster;
Contact third parties;
Contact the appointed representative;
Contact medical sources;
Attempt contact via prior claimant addresses and phone numbers;
Check jail and prison systems for incarceration;
Query systems that reflect an address for the claimant (for example, Master Beneficiary Record, Modernized Claims System, Modernized Diary Worksheet, and Modernized Supplemental Security Income Claims System screens);
Email or call the servicing FO to ask if they updated contact information for the claimant.
If the DDS needs to request FO assistance in locating a claimant, the DDS:
Completes any development that does not require the claimant’s participation;
Makes a determination based on the relevant evidence in file; and
Returns the case to the FO.
The existence of a WU situation alone does not support a denial determination. Depending on the evidence in file, deny the disability determination, allow a closed period, or allow an open period. Follow appropriate standards and criteria for development, evaluation, and determination of disability claims.
The DDS must:
Ensure that all less than fully favorable determinations include a thorough analysis on the Residual Functional Capacity/ Mental Residual Functional Capacity (RFC/MRFC) assessment or determination rationale about how the WU situation affects the disability determination;
Complete the Disability Determination and Transmittal SSA-831-U3 (Disability Determination and Transmittal) form;
Add “Claimant’s whereabouts unknown” to the Remarks section in Item 34 of form SSA-831-U3;
Show the claimant’s last known address in Item 5 of form SSA-831-U3;
Send the appropriate notice to the claimant at the claimant’s last known address; and
Return the case to the FO or, if selected for review, to the Disability Quality Branch.
DI 11055.085 Claimant Does Not Wish to Pursue Claim or Whereabouts Unknown (WU)
DI 11010.045 Claimant Cannot Be Contacted or Whereabouts Unknown or Claimant Does Not Wish to Pursue Title II Claim
DI 23007.005 Contacting the Claimant, Applicant, Appointed Representative, or Third Party in Claims Involving Failure to Cooperate and Insufficient Evidence