If an adjudicating component identifies FSF in a claim, the adjudicator is required to evaluate and disregard evidence as necessary, per DI 23025.025, when making the determination.
If an investigation unit (IU) (i.e., the Office of the Inspector General (OIG) or a Cooperative Disability Investigations Unit (CDIU)) completed an investigation, consider the report of investigation (ROI) or any additional documentation received in your review. Evidence in the case file may be discarded based on findings outlined in the ROI . If there is an ROI or any other investigative information in file when you receive the case for quality review, ensure that the adjudicating component weighed the evidence carefully and followed directions per DI 23025.025B.
The adjudicating component is required, in most cases, to hold the case until the investigation for FSF is complete. If you receive a claim with an open FSF investigation, returned to the adjudicating component. There are two exceptions per DI
If there is sufficent evidence in file to make a denial determination, the adjudicating component can make the determination. The investigatior stops his or her investigation and provides any existing documentation. The adjudicator add the available evidence to the claims file.
If the evidence in file supports an allowance determination based on other impairments than those suspected for FSF, the adjudicating component can make the determination.
IMPORTANT NOTE: If an ROI or any other investigatory information is received during the quality review, will treat it as trailer mail (see DI 22520.000).